【摘要】 目的对RA患者的影像学病情进展进行随访,探讨影响类风湿关节炎(rheumatoidarthritis,RA)预后的相关因素,为治疗方案的合理选择提供依据。方法对41例使用改善病情的抗风湿药物(DMARDs)治疗的RA患者双手相X线进展情况进行2-9年随访,采用多因素logistic回归分析性别、发病年龄、病程、起病关节、关节外表现、类风湿因子、抗核抗体、抗核周抗体、抗鼠食管角质层抗体、抗RA33抗体、HLA-DRB104等位基因等因素与RA预后的关系。结果根据Stein-brocker分期有无进展将41例RA分为两组,有进展组及无进展组的平均随访时间分别为(4.7±2.8)年和(3.8±1.5)年,差异无显著性(P=0.155,95%CI:0.375-2.280)。只有DRB104对RA影像学病情进展具有显著性意义(P=0.035,回归系数R=0.220,期望值Exp=6.753)。结论HLA-DRB1等位基因可作为估计RA病情及预后的指标。更多还原

【Abstract】 Aim Early diagnosis and intervention may provide the greatest benefit for reducing the deformity and disability in rheumatoid arthritis (RA), and the initial steps in the management are to make a appropriate estimate of prognosis. Consequently a follow up study was performed to investigate the correlative factors which may impact the prognosis in RA. Methods 41 cases of RA who had received disease modifying antirheumatic drugs (DMARDs) treatment were studied. All of them had taken X ray photographs of hands and followed up for 2-9 years. Use multivariate logistic regression analyses to analyze the factors which may impact the prognosis in RA such as sex, onset age, disease duration, onset joint, extraarticular involvements, rheumatoid factor (RF), antinuclear antibodies (ANA), antiperinuclear factor (APF), anti keratin antibodies (AKA), anti RA33 antibodies and HLA DRB104 alleles. Results Multivariate logistic regression analyses showed that DRB104 alleles were associated with the radiographic damage of RA(P=0.035). Conclusion DRB1 alleles genotyping may be useful in evaluating the disease severity and prognosis in RA.更多还原