Clinical Analysis Of Disease Activity In Rheumatoid Arthritis

Rheumatoid Arthritis ( RA ) is a kind of chronic advanced autoimmunedisease, which is characterized by inflammation of multiple and symmetric joints, especially small joints. It chiefly affects synovial membrane of multiple joints, sometimes other tissues, eg plasma membrane, blood vessels, nerves and so on. There are 4 million RA patients at lest in China. The prevalence in general population is 0.34%-0.36%, female patients outnumber males. The deformity is very common, which is characterized by damage and deformity of joints, even the disfunction of joints. The rate is high to 50% in two years for RA patients without treatment, and 70% in three years. If there is deformity of joint, it cannot be healing. It is reported that joints of 50%-90% RA patients have been damaged in imageology within 2 years after the onset of the disease, and the therapeutic effect is the best with treatment within 1 year, especially within 3 months. Thus, it is very important to diagnose early for holding damage of articulation and improving prognosis.Etiology of the disease is not clear. There is no cure for the disease and preventive measures. Due to the treatment of rheumatoid arthritis required long-term medication, and drug side effects of the same drug efficacy and side effects of individual differences, Therefore, the need to evaluate the condition of the sensitive indicators to guide treatment adjustment is urgent. In recent years, with the diagnosis and treatment level, patients will be able to earlier diagnosis and timely treatment. Effective treatment has also increased, so that the evaluation of the disease condition more complex, more demanding.Current rheumatoid arthritis disease activity evaluation and monitoring, include the subjective evaluation of clinicians to patient's disease and Supplementary examination. Clinicians'subjective evaluation, including a major assessment of the overall disease status of the patient and the evaluation of local disease such as arthritis, which inevitably includes the doctor's subjective opinion, different clinicians to the same evaluation of the patient and the same condition can occur in different results, so alone it is difficult for clinicians to accurately assess the disease status of the patient's objective.Clinically. Supplementary examinations are also used in evaluating the patient's disease activity to help clinicians better evaluate the patient's condition.C-reactive protein and erythrocyte sedimentation rate are the most commonly used to reflect disease activity in rheumatoid arthritis laboratory indicators. But they are not specific indicators. Research has shown that ESR and CRP with the radiological changes in rheumatoid arthritis has relevance. Recent studies have shown that platelet, RF factors, anti-CCP antibodies with rheumatoid arthritis also have relevance. This study is a retrospective study. To study the relationship between CRP, ESR, PLT, RF factors, anti-CCP antibodies and RA disease activity and bone erosion of rheumatoid arthritis.Objective: To analyze the relevance of commonly used indicators of inflammation and rheumatoid arthritis (rheumatoid arthritis, RA) activities, and to evaluate of their values of reflecting the activity of rheumatoid arthritis. Methods: 49 patients with rheumatoid arthritis visited in China and Japan Union Hospital affiliated to Jilin University during Jan 2007-Dec 2008 are selected as study objects.①According to disease activity they were divided into two groups, they were divided into 2 groups, A group that the disease activity group(DAS28 score greater than or equal to 3.2). B Group that is a low disease activity group (DAS28 score of less than 3.2). Comparise the number of swollen joints, the number of tender joints, ESR, CRP, DAS28, morning stiffness time, RF-IGG, RF-IGA, RF-IGM, RF-IGG, anti-CCP antibodies of the 2 groups. And calculate the Correlation coefficient of DAS28, number of swollen joints, tender joint count and CRP, ESR, PLT before treatment.②According to platelet count they were divided into 2 groups, thrombocytopenia in normal group (100 ~ 300×109/ L) and platelet increased group (more than 300×109 / L).We comparise the number of swollen joints, tender joints number, ESR, CRP, DAS28, morning stiffness time, RF-IGG, RF-IGA, RF-IGM, RF-IGG, anti-CCP antibodies between the two groups.③According to the Sharp score, they were divided into bone erosion of RA patients and non-bone erosion group, we compare the course of disease, DAS28, ESR, CRP, number of swollen joints, tender joints number, time of morning stiffness, RF classification, PLT, anti-CCP antibodies between the two groups .The results:①A group of CRP, ESR,PLT, the number of joint tenderness, the number of swelling joints, RF-IGG, RF-IGA, RF-IGM are higher than the B group, P <0.05. A group of anti-CCP antibodies higher than the B group, but P >0.05.②A group (activity disease group):DAS28, number of swollen joints, tender joint count and CRP, ESR are significantly related, PLT is significantly correlated with the DAS28, but PLT is not related to the number of joints with swelling, joint tenderness. B group (low disease activity group): DAS28 and CRP, ESR are significant related to DAS28, but PLT is not significant related to DAS28, CRP, ESR, PLT are not significant related with the number of swollen joints, tender joint count.③Increased platelet groups: the number of swollen joints, number of joint tenderness, ESR, CRP, DAS28, morning stiffness time, RF-IGG, RF-IGA, RF-IGM, platelets are significantly higher than the normal group, while Anti-CCP antibodies is not significant difference between with the two groups. Increased platelet group: PLT is significantly related to the time of morning stiffness, the number of swellen joints, the number of tender joints, ESR, CRP, RF-IGG, RF-IGA, RF-IGM, but PLT is not significantly related to anti-CCP antibodies.④Disease course, anti-CCP antibodies, PLT, RF-IGM, RF-IGA, CRP are significantly related to bone erosion, while DAS28, ESR, number of swollen joints, number of joint tenderness, morning stiffness, RF-IGG are not significantly related with bone erosion .Conclusion:①CRP can reflect the activity of RA, and It is better than the ESR, It can prompt the occurrence of bone erosion.②ESR can reflect the disease activity of RA, but It can not prompt the occurrence of bone erosion.③PLT can reflect the disease activity of RA disease activity, PLT may be involved in increasing the incidence of bone erosion.④RF-IGG, RF-IGM, RF-IGA can reflect the disease activity of RA. And RF-IGM, RF-IGA can prompte the bone erosion, but RF-IGG can not prompre the bone erosion.⑤anti-CCP antibody associates to bone erosion. But It has nothing to do with RA disease activity.