2011年ACR/EULAR类风湿关节炎缓解标准与其他常用标准的比较

摘要

Objective:To evaluate and compare the advantage and utility of the 2011 ACR/EULAR criterion and the other remission criteria of rheumatoid arthritis. Methods: The questionnaires for RA patients were used for the study. The remission rate and residual disease activity of RA patients were compared according to four criteria of remission, including 2011 ACR/EULAR remission criterion, DAS28, CDAI and ACR. Results: Among the 310 cases, 254 effective questionnaires were obtained. The remission rates of ACR, CDAI, ACR/EULAR and DAS28 were 15.4% , 23.2% ,25. 2% ,38.2% , respectively. ACR criteria is the most stringent criteria, the remission rate of ACR was significantly lower than the other three criteria (P < 0.05). There was no residual disease activity of ACR criteria. DAS28 criteria is the laxest criteria, the remission rate and residual disease activity of DAS28 was significantly higher than the other three criteria (P < 0. 05). There was no difference between CDAI and ACR/EULAR, which were more suitable for clinical practice. Conclusion: Among the four criteria, ACR criteria is the most stringent criteria, DAS28 criteria is the laxest criteria, The CDAI and ACR/EULAR criteria were more suitable for clinical practice.%目的:了解201 1年ACR/EULAR类风湿关节炎(rheumatoid arthritis,RA)缓解标准与其他常用缓解标准的优劣及临床实用性.方法:现场问卷调查门诊或住院的RA患者,使用2011年ACR/EULAR、1981年ACR、DAS28及CDAI四种缓解标准进行评价,了解各缓解标准的缓解率及达到缓解患者的残余疾病活动度(residual disease activity)情况,对相关标准进行比较,评价各种标准的相关性、差异性和优缺点.结果:共完成调查问卷310份,其中有效问卷254份,有效率81.9％.1981年ACR、CDAI、2011年ACR/EULAR、DAS28缓解标准的缓解率分别为15.4％、23.2％、25.2％、38.2％,差异有统计学意义.ACR标准最为严格,其缓解率低于其他缓解标准,差异有统计学意义(P＜0.05),无残余疾病活动度,而DAS28标准最为宽松,其缓解率高于其他缓解标准,差异有统计学意义(P＜0.05),残余疾病活动度高于其他三种缓解标准,差异有统计学意义(P＜0.05).CDAI标准、2011年ACR/EULAR标准在缓解率及残余疾病活动度方面介于ACR及DAS28标准之间,但计算简单,适于临床应用.结论:4种RA缓解标准中ACR标准最严格,无残余疾病活动度；DAS28标准最宽松,计算复杂,残余疾病活动度最高；CDAI、2011年ACR/EULAR标准计算简单,实用性强.