慢性関節リウマチの寛解導入に関連する予測因子の検討

概要

論文の詳細を見る
We conducted a retrospective controlled study to determine prognostic factors related with remission in patients with rheumatoid arthritis (RA). A total of 90 outpatients with RA who fulfilled the American Rheumatism Association preliminary criteria for clinical remission in RA were randomly selected and then compared to 90 RA patients with persistent synovitis. Patients were categorized into three groups: those whose disease duration at the initial visit was less than 0.5 years, 0.5 to 2 years, or more than 2 years were assigned to groups A, B, and C, respectively. Clinical characteristics were compared among groups. Since only a few variables differed significantly within groups A and B, it was difficult to predict remission in patients whose disease duration was less than 2 years. In group C, ESR ≧50 mm/h, IgG ≧1800 mg/dl, IgA ≧350 mg/dl RAPA ≧160, ANA ≧40, and the number of erosive joints in hands ≧4 were established as factors predicting persistent arthritis. The presence of three or more of these variables in a patient whose disease duration was more than 2 years yielded 80% sensitivity and 77% specificity against patients with persistent arthritis. This finding suggested that clinical remission rarely occurs in patients who meet the criteria.
2001-06-25