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J Rheumatol：类风湿性关节炎MRI评分可以预测治疗反应

2018-04-12 xiangting MedSci原创

类风湿性关节炎MRI预测因子治疗反应
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基线总RAMRIS评分可以预测EULAR反应。第二个MCP关节处的RAMRIS滑膜炎评分和RANKL分别与应答和缓解相关。

类风湿性关节炎（RA）的治疗反应缺乏标记物。这项研究的目的是评估RA磁共振成像（MRI）评分系统（RAMRIS）与血清生物标志物联合用于预测早期初治RA患者对甲氨蝶呤（MTX）治疗反应的表现。

纳入28例RA患者，在基线、MTX后3个月和6个月对临床优势手进行3T MRI前瞻性评估。这些患者符合2010年美国风湿病学会/欧洲抗风湿联盟（EULAR）标准[平均年龄56.8岁（范围39-74）; 类风湿因子和/或抗环瓜氨酸肽抗体阳性; 病程<6个月（范围2-23周）]。取得由各种实验蛋白（包括核因子-κB配体的受体激活剂（RANKL））组成的RAMRIS和血清生物标志物。根据EULAR定义缓解或治疗反应。为了调整内部相关性，使用了广义线性混合模型。

3个月的治疗反应与RAMRIS侵蚀单项分值低和总RAMRIS评分低相关（分别为p = 0.019和0.03）。6个月的缓解与RANKL水平低相关（p = 0.033）。在多变量分析中，纳入RAMRIS总分、第二掌指关节（MCP）的RAMRIS滑膜炎评分，或两者的组合（p值似然比检验= 0.035,0.035 和0.041）可以更准确地预测3个月和6个月的治疗反应。纳入RANKL可以更准确地预测缓解，MRI没有显著的预测效果。

基线总RAMRIS评分可以预测EULAR反应。第二个MCP关节处的RAMRIS滑膜炎评分和RANKL分别与应答和缓解相关。

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    2018-04-14 lmm397

    #关节炎#

    0

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    2018-04-14 ms4964546379600229

    #类风湿#

    0

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    2018-04-14 ms1467340776200723

    #风湿性关节炎#

    0

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    2018-04-13 1ddf0692m34(暂无匿称)

    学习了.长知识

    0

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    2018-04-12 lietome2

    好文.值得点赞!认真学习了.把经验应用于实践.为患者解除病痛.

    0

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RA患者生活质量和幸福感的优化需要对病程进行有效控制，并改善疾病影响域。性格似乎在这些关系中扮演着关键的介导角色。

J Rheumatol：类风湿性关节炎中抗风湿药物和疫苗免疫原性的Meta分析

抗风湿药物可能会限制疫苗的体液反应，这可以由MTX暴露的肺炎球菌反应证明; 然而它们是安全的，我们不应该阻止针对疫苗可预防疾病的免疫接种。