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標題: | 不同兒童特發性關節炎分型的疾病活性與發炎生物標記的相關性 The correlations between disease activity and inflammatory biomarkers in different subtypes of juvenile idiopathic arthritis |
作者: | Yung-Hsien Huang 黃永賢 |
指導教授: | 江伯倫(Bor-Luen Chiang) 江伯倫(Bor-Luen Chiang | gicmbor@ntu.edu.tw | ), |
關鍵字: | 兒童特發性關節炎,疾病活性,醫師整體評估,發炎生物標記, juvenile idiopathic arthritis,disease activity,physician global assessment,inflammatory biomarkers, |
出版年 : | 2022 |
學位: | 碩士 |
摘要: | 目的: 臨床上我們會檢驗常規的發炎生物標記去監測兒童特發生關節炎的疾病活性,但在不同的分型, 其相關性可能會有差異。本研究的目的是探討不同兒童特發性關節炎分型的疾病活性與發炎生物標記的相關性。 方法: 我們搜集從2018年3月到2019年12月在台大醫院門診看診有做抽血檢驗的兒童特發性關節炎的病童病歷,總共92人次,記錄當下疾病活性的醫師整體評估(Physician Global Assessment)、兒童健康評估問卷的失能指標(Childhood Health Assessment Questionnaire- disability index)、以及抽血的結果,包括白血球數、血色素、血小板數、C-反應蛋白(CRP)、紅血球沉降速率(ESR)、補體3和4 (C3和C4)。分析醫師整體評估與這些檢驗數據的相關性。 結果: 在寡關節炎(Oligoarthritis)的病人,醫師整體評估與這些檢驗數據沒有明顯統計的相關性。在多關節炎(Polyarthritis)的病人,醫師整體評估與CRP、ESR和C4有中度正相關(rho=0.469, p=0.004; rho=0.601, p=0.000; rho=0.441, p=0.015)。接骨點炎型關節炎的病人,醫師整體評估與血小板,CRP, C3, 和C4呈中度正相關(rho=0.448, p=0.037; rho=0.439, p=0.041; rho=0.519, p=0.033; rho=0.510, p=0.036),而和血色素呈中度負相關(rho=-0.493, p=0.020)。在醫師整體評估大於等於10以上的病人,寡關節病人的醫師整體評估與白血球數呈中度負相關(rho=-0.693, p=0.026); 多關節炎的病人醫師整體評估與CRP和ESR呈中度正相關(rho=0.527, p=0.012; rho=0.665, p=0.001); 接骨點炎型關節炎的病人,醫師整體評估與血小板呈強度正相關,雖然沒有達到顯著統計意義(rho=0.750, p=0.052)。 結論: 不同分型的兒童特發性關節炎的病人在疾病活性與發炎生物標記的相關性有各自的特性,了解這樣的差別可以幫助我們對於不同分型的兒童特發性關節炎的檢驗數據判讀更加精準。 Background: The Physician Global Assessment (PGA) has been widely used to evaluate disease activity of juvenile idiopathic arthritis (JIA), and it is simple for physicians to perform. Laboratory tests including WBC, Hb, PLT, ESR, CRP, C3, and C4 are routinely performed to provide objective parameters for JIA evaluation, but they are barely moderate correlated with disease activity in whole patients with JIA. JIA consists of seven different subtypes, there may be different correlations between disease activity and inflammatory biomarkers in each subtype. In the study, we investigated the correlations between disease activity and inflammatory biomarkers in different juvenile idiopathic arthritis subtypes. Methods: Ninety-two patients with JIA were retrospectively recruited in this study. The PGA score and inflammatory biomarkers including WBC, Hb, PLT, ESR, CRP, C3, C4 were collected. The correlations among the PGA score, the Childhood Health Assessment Questionnaire‐disability index (CHAQ-DI), and laboratory data were analyzed in different subtypes of JIA. Results: There were no strong or moderate correlations between the PGA score and the biomarkers in whole patients with JIA. The PGA score was moderately positively correlated with CRP, ESR, C4 (rho=0.469, p=0.004; rho=0.601, p=0.000; rho=0.441, p=0.015) in patients with polyarthritis, and was moderately negatively correlated with Hb (rho=-0.493, p=0.020) and was moderately positively correlated with PLT, CRP, C3, and C4 (rho=0.448, p=0.037; rho=0.439, p=0.041; rho=0.519, p=0.033; rho=0.510, p=0.036) in patients with Enthesitis related arthritis (ERA). When the patients’ PGA were above 10, the PGA score was moderately negatively correlated with WBC (rho=-0.693, p=0.026) in those with oligoarthritis, was moderately positively correlated with CRP and ESR (rho=0.527, p=0.012; rho=0.665, p=0.001) in those with polyarthritis, and was strongly positively correlated with PLT without statistical significance (rho=0.750, p=0.052). Conclusion: The correlations between disease activity and inflammatory biomarkers were different in different subtypes of JIA. The results can help us make better interpretations of the biomarkers in these patients. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/84799 |
DOI: | 10.6342/NTU202203019 |
全文授權: | 同意授權(限校園內公開) |
電子全文公開日期: | 2022-10-05 |
顯示於系所單位: | 臨床醫學研究所 |
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