| Objective To compare the changes of simplified joint ultrasound score and serum level of interleukin-6(IL-6)in different clinical stages of rheumatoid arthritis(RA),to explore the value of simplified joint ultrasound score and serum level of interleukin-6 in assessing rheumatoid arthritis disease activity.Methods Retrospective analysis: a total of 80 RA patients(20 males and 60 females)admitted to the department of rheumatology and immunology,the Yantai Yuhuangding Hospital affiliated to Qingdao University from December 2017 to December 2018.All the patients were diagnosed by the 1987 ACR diagnostic RA standard or ACR/EULAR 2010 criteria.Based on DAS28-ESR(Disease activity score28,DAS28)score that calculated by ESR the patietes were divided into 4 groups: Remission(DSA28-ESR<2.6),Mild(DAS28-ESR2.6-3.2),Moderate(DAS28-ESR 3.2-5.1)and Severe(DAS28-ESR>5.1).Each group contained 20 patients,and collect clinical data,laboratory examination,serum IL-6 and joint ultrasound(double wrist joint,double hands MCP2,MCP3,MCP5)examination,and record data.Kruskal-wallis test was used to study the differences of serum IL-6 level and simplified joint ultrasonic score in different disease activity groups.Spearman correlation was used to study the relationship between serum IL-6 and simplified joint ultrasound,clinical test indexes and DAS28-ESR.The difference was statistically significant at P < 0.05.Results 1.There were no significant differences in age,gender and course of disease among the four groups of patients: Remission,Mild,Moderate and Severe(P>0.05);2.The serum IL-6 level of RA patients in Remission was significantly different from that in Mild,Moderate and Severe(P<0.05);Serum IL-6 levels were highly positively correlated with DAS28-ESR,erythrocyte sedimentation rate,CRP,SAA,simplified joint ultrasound score,synovial score,power Doppler flow score,and joint effusion score(P<0.05);3.In RA patients with normal ESR and/or normal CRP,the patients have a significant increase in serum IL-6 levels,with no significant difference(P>0.05);4.There was a statistically significant difference between Remission of RA and the Mild,Moderate,and Severe in simplifying the joint ultrasound score,synovial score,power Doppler flow,and joint effusion score(P<0.05);There was no significant difference in bone erosion score among the four groups(P>0.05).In the simplified joint ultrasound score of the Severe,the percentage of synovial membrane,energy doppler flow and joint effusion with high score were higher than Remission,while the percentage of low score was lower than Remission;5.Simplified joint ultrasound score was positively correlated with DAS28-ESR,number of tender joints,number of swollen joints,serum IL-6,CRP,erythrocyte sedimentation rate,and SAA(P<0.05);6.Anti-CCP antibody titer was significantly positively correlated with bone erosion score(P<0.05).Conclusion 1.The serum IL-6 level of RA patients was positively correlated with DAS28-ESR,ESR and CRP,which could be used as an evaluation index of RA disease activity.2.Joint ultrasound can be used to observe the specific involvement of joints in RA patients.3.Simplified joint ultrasound score,synovitis score,Doppler blood flow signal score and DAS28-ESR score were significantly positively correlated,suggesting that it can be used as an evaluation index for RA disease activity.4.Joint ultrasound can detect joint inflammation in clinical remission.5.Anti-CCP antibody had a predictive effect on bone erosion. |
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