İleri Dönem Romatoid Artrit Ra Hastalarında Anti-Siklik Sitrülinlenmiş Peptid Anti-Ccp Antikorunun Hastalık Aktivitesi İle İlişkisi Ve Prognostik Değeri

Year 2009, Volume: 66 Issue: 2, 35 - 47, 01.06.2009

Irmak Baran Aşkın Ateş Sebahat Aksaray Alparslan Toyran Engin Güvener

Abstract

Amaç: Anti-siklik sitrülinlenmiş peptid anti-CCP antikorları romatoid artrit RA tanısında son yıllarda kullanılmaya başlanmış yüksek özgüllük ve duyarlılığa sahip belirteçlerdir. Bu çalışmada ileri dönem RA hastalarında anti-CCP antikorlarının hastalık aktivitesi, radyolojik olarak saptanan eklem hasarı ile ilişkisinin ve prognostik değerinin araştırılması amaçlanmıştır.Yöntem: İleri dönem 122 RA hastası ve 50 sağlıklı kontrolde anti-CCP antikoru ve romatoid faktör RF titreleri ölçülmüştür. Hastalık aktivitesinin değerlendirilmesinde; hassas eklem sayısı HES , şiş eklem sayısı ŞES , vizuel analog skala VAS ’ya göre ağrı şiddeti, sabah tutukluğu süresi, hastaya ve hekime göre global hastalık aktivitesi skoru, 28 eklemde hastalık aktivesi skoru DAS 28 , eritrosit sedimantasyon hızı ESH , lökosit sayısı, C-reaktif protein CRP düzeyi kullanılmıştır. Fonksiyonel aktivite sorgulanması Health Assessment Questionnaire HAQ , eklem hasarının radyolojik değerlendirilmesi Larsen Yöntemi ile yapılmıştır.Bulgular: Hastaların %66.4’ünde anti-CCP antikoru, %59’unda RF pozitif bulunmuştur. RA hastalarında; anti-CCP titresi ile RF titresi r=0.582, p

Keywords

Romatoid artrit, anti-CCP antikoru, romatoid faktör, prognoz, hastalık aktivitesi

Association of anti-cyclic citrulinated peptide anti-CCP antibody with disease activity in advanced rheumatoid arthritis patients and its prognostic value

Abstract

Objective: Anti-cyclic citrullinated peptide anti-CCP antibodies are highly specific and sensitive markers which are used in the diagnosis of rheumatoid arthritis RA , in recent years. In this study it was aimed to investigate the association of anti-CCP antibodies with disease activity and radiological joint damage in advanced RA patients and the prognostic value of anti-CCP antibodies. Method: Titers of anti- CCP antibodies and rheumatoid factor RF in 122 advanced RA patients and 50 healthy controls had been searched. In order to determine the activity of the disease , tender joints count TJC , swollen joints count SJC , visual analog scale VAS for pain, duration of morning stiffness, patient’s and physician’s global assessment, disease activity score for 28 joints DAS 28 , erythrocyte sedimentation rate ESR , leukocyte count and C-reactive protein CRP were evaluated. Functional activity assessment and radiological joint damage were carried out according to the Health Assessment Questionnaire HAQ and Larsen method, respectively.Results: 66.4% were positive for anti-CCP antibodies and 59% were positive for RF of the patients. In patients with RA, significant correlations were found between serum anti-CCP level and RF level r=0.582, p

Keywords

Rheumatoid arthritis, anti-CCP antibody, rheumatoid factor, prognosis, disease activity

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