The Clinical Analysis Of Disease Activity Of96Cases Of Rheumatoid Atrhritis

CRP and ESR are two classic inflammatory activity indicators which are most commonlyused for clinical evaluation of RA activity. However, neither of them is the most specificindicators to evaluate the RA disease activity. Research has shown that there is a significantcorrelation between the radiation changes and CRP. DAS28is a comprehensive assessmentindex of disease activity in RA, which can evaluate disease activity objectively andcomprehensively. Research has shown that the DAS28is the best standard for the definition ofRA disease activity whether in high state or not. However, DAS28score needs to obtainadequate clinical and laboratory data, and the calculation process is cumbersome. Thedifferences in patients with various social and economic backgrounds can also affect theoutcome of the assessments. Recently researches on the relationship between the changes of theblood system, such as red blood cells, platelet and RA disease activity show that there iscorrelation between them. But the studies of the differences of relationship between differentindexes with RA activity are rare.This study is a retrospective study aiming at studying the relationships between ESR, CRP,WBC, RBC, HGB, MCV, MCH, PLT, PCT, MPV, PDW and other experimental indexes and RAdisease activity index DSA28.Objective: To analyze the relationships between the commonly used experiment indexes inclinical and the RA disease activity, evaluate and compare the value of these indexes inreflecting RA disease activity.Methods: Clinical data of96cases hospitalized patients with rheumatoid arthritis fromdepartment of rheumatology of the second part of the First Hospital of Jilin University wereretrospectively analyzed. In control, we chose40cases of normal, healthy volunteers from ourhospital medical center whose ages and genders matched the cases above. RA patients weredivided into elderly group and non-elderly group. And then according to DAS28, we divided thetwo groups above into the disease active subgroup and the remission subgroup. ESR, CRP,WBC, RBC, HGB, MCV, MCH, PLT, PCT, MPV, PDW and other experimental indexes were respectively compared between RA group and its normal control group. And we calculated andcompared the relationships between the indexes above and DAS28in each group.Results:1.In the disease active subgroup of the ERA, the CRP, ESR, PLT, PCT weresignificantly higher than those of the remission subgroup and the elderly normal control group,the RBC, HGB, MCH, MPV were significantly lower than those of the remission subgroup andthe elderly normal control group. There was no significant difference in the WBC, MCV andPDW among above groups.2. In the disease active subgroup of the NERA, the CRP, ESR, PLT,PCT were significantly higher than those of the remission subgroup and the non-elderly normalcontrol group, the RBC, HGB, MCH, MPV were significantly lower than those of the remissionsubgroup and the non-elderly normal control group. There was no significant difference in theWBC, MCV and PDW among above groups.3. In the remission subgroup of the NERA andERA, the CRP, ESR, PLT, PCT were significantly higher than those of the normal control group,the RBC, HGB, MCH were significantly lower than those of the normal control group. Therewas no significant difference in the WBC, MCV, MPV and PDW among above groups.4. In thedisease active subgroup and the remission subgroup of the ERA group, DAS28was positivelycorrelated with CRP, ESR, PLT and PCT. And it was negatively correlated with RBC, HGB,MCH and MPV. There was no significant correlation between DAS28and WBC, MCV, PDW inthese groups. As to the correlation coefficients, CRP was the highest, followed by ESR, theblood system parameters were the lowest.5. In the disease active subgroup and the remissionsubgroup of the NERA group, DAS28was positively correlated with CRP, ESR, PLT and PCT.And it was negatively correlated with RBC, HGB, MCH and MPV. There was no significantcorrelation between DAS28and WBC, MCV, PDW in these groups. As to the correlationcoefficients, CRP was the highest, followed by ESR, the blood system parameters were thelowest.6. In the disease active subgroup of the NERA group, the correlation coefficients of ESRand RBC, HGB, MCH with DSA28were higher than those in the disease active subgroup of theERA group. There was no significant difference in the correlation coefficients of other indexesamong above groups.7. There was no significant difference in the correlation coefficients ofindexes between the remission subgroup of the NERA group and the ERA group.Conclusions:1. The CRP, ESR, RBC, HGB, MCH, PLT, MPV and PCT are significantly correlated with the RA disease activity index DAS28which suggests that all the indexes abovecan be used in assessing the RA disease activity.2. CRP is the best index in assessing the RAdisease activity.3. ESR and RBC, HGB, MCH play a better role in assessing the RA diseaseactivity in NERA disease activity group than in ERA disease activity group.