赵岩 类风湿关节炎十年科目讲解.pptVIP

RA疾病活动度的评价体系 反应率（ACR20/50/70 和 EULAR反应率） 缓解率（DAS44/28、CDAI或SDAS临床缓解） Van Gestel AM, et al. Arthritis Rheum 1996;39:34–40 Felson DT, et al. Arthritis Rheum 1995;38:727–35 Aletaha D, et al. Arthritis Res Ther 2005;7:R796–806 Prevoo ML, et al. Arthritis Rheum 1995;38:44–8 ACR20 RA改善标准 ≥20% 改善 TJC，SJC，和 At least 3 of the following： ESR or CRP Investigator assessment of global disease activity Patient assessment of pain Physical disability Adapted from van Gestel AM,et al.J Rheumetol 1999,26:705-711. 2.American College of Rheumetology Subcommittee on Rheumatoid Arthritis Guidelines. Arthritis Rheum. EULAR Response Criteria: DAS44 and DAS28 1-3 DAS44 at End Point Improvement in DAS44 From Baseline 1.2 0.6 and ≤1.2 ≤0.6 ≤2.4 Good Response 2.4 and ≤3.7 Moderate Response 3.7 No Response DAS28 at End Point Improvement in DAS28 From Baseline 1.2 0.6 and ≤1.2 ≤0.6 ≤3.2 Good Response 3.2 and ≤5.1 Moderate Response 5.1 No Response 1.Van Gestel AM.et al.Arthritis Rheum.1993,41:1845-1850. 2.Van der Heijde DMFM.et al.J Rheumetol.1993,20:579-581. 3.Van Gestel AM.et al.J Rheumetol.1999,26:705-711. 4. Van Gestel AM,et al Arthiritis Rheum,1996,39:34-40. 常用RA疾病活动度评分系统比较 ACR DAS28 SDAI CDAI PAS/ RAPID # Tender joints √ √ √ √ -- # Swollen joints √ √ √ √ -- MD global √ - √ √ -- ESR or CRP √ √ √ -- -- Patient function √ -- -- -- √ Patient pain √ -- -- -- √ Patient global √ √ √ √ √ 　 　 疾病活动度的分度 指 标 评分范围 低 中 高 28个关节疾病活动度评分 (Disease Activity Score in 28 joints) 0-9.4 ≤3.2 3.2 且 ≤ 5.1 5.1 简化的疾病活动度指标 (Simplified Disease Activity Index) 0.1-86.0 ≤ 11 11 且≤26 26 临床疾病活动度指标 (Clinical Disease Activity Index) 0-76 ≤ 10 10 且 ≤ 22 22 RA疾病活动度指标 (RA Disease Activity Index) 0-10 2.2 ＞2.2 且 ≤ 4.9 4.9# 患者活动评分 Patient Activity Scale,PAS或PASII 0-10 1.9 ＞1.9 且 ≤ 5.3 5.3 常规患者评估指标数据(Routine Assessment Patient Index Data) 0－30 6 ＞6 且≤ 12 12 DAS评分系统的优缺点 DAS28 = 0.56*√(TJC28) + 0.28*√(SJC28) + 0.70*lnESR + 0.014*总体评价 DAS评分系统(Disease Activity Score, DAS) 临床缓解：DAS28 ＜2.6 简化的疾病活动性评