DISEASE SEVERITY IN RHEUMATOID-ARTHRITIS - RELATIONSHIPS OF PLASMA TUMOR-NECROSIS-FACTOR-ALPHA, SOLUBLE INTERLEUKIN 2-RECEPTOR, SOLUBLE CD4/CD8 RATIO, NEOPTERIN, AND FIBRIN D-DIMER TO TRADITIONAL SEVERITY AND FUNCTIONAL MEASURES
DISEASE SEVERITY IN RHEUMATOID-ARTHRITIS - RELATIONSHIPS OF PLASMA TUMOR-NECROSIS-FACTOR-ALPHA, SOLUBLE INTERLEUKIN 2-RECEPTOR, SOLUBLE CD4/CD8 RATIO, NEOPTERIN, AND FIBRIN D-DIMER TO TRADITIONAL SEVERITY AND FUNCTIONAL MEASURES
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DOI：
10.1007/bf00920793
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发表时间：
1992-09-01
影响因子：
9.1
通讯作者：
WEINBERG, JB
中科院分区：
文献类型：
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作者：
BECKHAM, JC;CALDWELL, DS;WEINBERG, JB
类风湿关节炎是一种原因不明的复杂炎症性疾病。尽管各种实验室和临床测量可用于管理这些患者，但仍需要更好的测试来定量评估疾病活动性。本研究的目的是调查类风湿性关节炎患者的某些免疫和炎症 (I-I) 参数与四种传统疾病严重程度测量和功能测量的关联。对一组患者血液样本进行了分析，并从 64 名连续门诊类风湿性关节炎患者中确定了四种传统的疾病严重程度和患者功能状态。分析血浆肿瘤坏死因子-α (TNF)、可溶性白介素-2 受体 (sIL-2R)、sCD4 和 sCD8（以及 sCD4/sCD8 比率）、新蝶呤和纤维蛋白 D-二聚体与 Westergren 红细胞沉降率 (ESR)、医生对疾病活动度的评估、关节疼痛计数、握力和关节炎影响测量量表 (AIMS) 评分的关系。与健康受试者相比，类风湿性关节炎患者的所有 I-I 测量值（sCD4 除外）的平均水平较高。最初检测到 TNF、sIL-2R 和 D-二聚体与多种疾病严重程度和功能指标之间存在显着相关性。当我们控制协变量年龄、性别、种族和药物时，回归分析表明，作为一个组，I-I 测量值与握力、医生疾病严重程度评级、ESR 和总关节疼痛显着相关。当控制协变量和 ESR 来测试 I-I 测量的预测值时，D-二聚体与握力、医师疾病严重程度和 AIMS 身体残疾的变异性独立且显着相关，而 TNF 与总关节疼痛的显着变异性相关。结果表明，类风湿性关节炎患者的这些免疫和炎症参数可能显着升高，并且某些测量（例如血浆纤维蛋白 D-二聚体）可能对于客观评估 RA 患者的疾病活动度特别有用。
Rheumatoid arthritis is a complex inflammatory disease of unknown cause. Although various laboratory and clinical measurements are useful in managing these patients, there is a need for better tests to quantitatively assess disease activity. The purpose of this study was to investigate the association of certain immune and inflammation (I-I) parameters with four traditional disease severity measures and a functional measure in rheumatoid arthritis patients. A single set of patient blood samples was analyzed, and four traditional disease severity measures and patient functional statuses were determined from 64 consecutive outpatients with rheumatoid arthritis. Plasma tumor necrosis factor-alpha (TNF), soluble interleukin-2 receptor (sIL-2R), sCD4 and sCD8 (and the sCD4/sCD8 ratio), neopterin, and fibrin D-dimer were analyzed in relationship to Westergren erythrocyte sedimentation rate (ESR), physician assessment of disease activity, joint pain count, grip strength, and Arthritis Impact Measurement Scale (AIMS) scores. Rheumatoid arthritis patients had higher mean levels of all I-I measures (except sCD4) compared to healthy subjects. Initial significant correlations between TNF, sIL-2R, and D-dimer and several disease severity and functional measures were detected. When we controlled for the covariates age, gender, race, and medications, regression analyses indicated that, as a group, the I-I measures were significantly related to grip strength, physician disease severity rating, ESR, and total joint pain. When the predictive values of the I-I measures were tested controlling for the covariates and ESR, D-dimer was independently and significantly associated with variability in grip strength, physician disease severity, and AIMS physical disability, while TNF was associated with a significant amount of variability in total joint pain. The results indicate that these immune and inflammation parameters may be significantly elevated in rheumatoid arthritis patients and that certain measures (e.g., plasma fibrin D-dimer) may be especially useful in objectively evaluating disease activity in RA patients.