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病情活动性指标ASDAS、RAPID3和BASDAI在判断强直性脊柱炎患者疾病活动度中的比较
宋婧,周凌,陈凌,吴歆*,徐沪济*
0
(第二军医大学长征医院风湿免疫科, 上海 200003
*通信作者)
摘要:
目的 研究ASDAS和RAPID3对强直性脊柱炎(ankylosing spondylitis,AS)患者疾病活动度的判断价值。 方法 对82例AS患者进行问卷调查,统计其一般情况、病情活动度指标,抽取静脉血测定红细胞沉降率(erythrocyte sedimentation rate,ESR)和C反应蛋白(C-reactive protein,CRP)水平。通过相关性分析、kappa一致性检验比较传统方法Bath强直性脊柱炎病情活动性指数(BASDAI)与新型方法ASDAS、RAPID3对疾病活动度的评估价值。 结果 ASDAS-CRP与RAPID3具有较好的一致性(kappa值: 0.788),而这两者与BASDAI的一致性检验结果不理想(kappa值: 0.342, 0.367)。BASDAI、ASDAS、RAPID3与医生总体评价(DOCGL)、患者自身评价(PATGL)均具有良好的相关性,其中ASDAS、RAPID3与DOCGL、PATGL的相关性明显强于BASDAI与DOCGL、PATGL的相关性(ASDAS-CRP、ASDAS-ESR、RAPID3、BASDAI与DOCGL的相关性分析r值分别为0.684、0.720、0.642及0.576;与PATGL的相关性分析r值分别为0.822、0.816、0.851及0.725)。 结论 ASDAS对AS疾病活动的评估能力优于BASDAI,是理想的评价疾病活动度的新指标,值得推广应用;RAPID3具有方便、简洁、不受实验室检查结果限制的特点,在评价AS活动度时同样具有良好的可靠性及有效性。
关键词:  强直性脊柱炎  BASDAI  ASDAS  RAPID3
DOI:10.3724/SP.J.1008.2015.00909
投稿时间:2015-07-05修订日期:2015-08-06
基金项目:
Comparison of ASDAS, RAPID3 and BASDAI in assessing disease activitiy of patients with ankylosing spondylitis
SONG Jing,ZHOU Ling,CHEN Ling,WU Xin*,XU Hu-ji*
(Department of Rheumatology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
*Corresponding authors)
Abstract:
Objective To investigate the values of ASAS-endorsed disease activity score (ASDAS) and routine assessment of patient index data 3 (RAPID3) in assessing disease activity of patients with ankylosing spondylitis (AS) in China. Methods Questionnaires were used to obtain the general information and disease activity of 82 AS patients; and erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured in the venous blood samples. Correlation analysis and kappa consistency test were used to compare the value of traditional measures for assessing disease activity of AS including Bath ankylosing spondylitis disease activity index (BASDAI) with the new measures including ASDAS and RAPID3. Results ASDAS-CRP and RAPID3 had a good consistency in assessing AS activity (kappa value: 0.788), but both of them had poor consistency with BASDAI (kappa values: 0.342, 0.367). BASDAI, ASDAS and RAPID3 were well correlated with doctor global assessment (DOCGL) and patient global assessment (PATGL), and ASDAS and RAPID3 had stronger correlation with DOCGL and PATGL than BASDAI did (the r values of ASDAS-CRP, ASDAS-ESR, RAPID3, and BASDAI with DOCGL were 0.684, 0.720, 0.642 and 0.576; and those with PATGL were 0.822, 0.816, 0.851 and 0.725, respectively). Conclusion ASDAS is superior to BASDAI in assessing the disease activity of AS, making it a new promising index for evaluating disease activity and worth promoting. RAPID3 is convenient, simple, and independent to laboratory findings, and it has a good reliability and validity in evaluating disease activity of AS.
Key words:  ankylosing spondylitis  BASDAI  ASDAS  RAPID3