Romatoid Artritte Hastalık Aktivite Skorları Ile Kemik Mineral Yoğunluğu Arasındaki Ilişki

Yıl 2014, Cilt: 4 Sayı: 3, - , 28.06.2014

Mehmet Uçar

Öz

Romatoid Artritte Hastalık Aktivite Skorları Ile Kemik Mineral Yoğunluğu Arasındaki  Ilişki

Amaç: Çalışmamızda Romatoid Artritli hastalarda hastalık aktivite skorları ile kemik mineral yoğunluğu arasındaki ilişkiyi araştırdık.

 

Metod: Çalışmaya Amerikan Romatizma Birliği (ACR) kriterlerine göre RA tanısı konulan ve kliniğimiz de izlenmekte olan 50 kadın hasta alındı. Olguların demografik özellikleri, şiş ve hassas eklem sayıları, hasta ve doktorun hastalık aktivitesini global değerlendirimi Vizüel ağrı skalası (VAS) ile, laboratuar verilerinden eritrosit sedimantasyon hızı ve

C-reaktif protein ve kemik mineral yoğunluğu düzeyleri kaydedildi. Klinik skorlar olarak Sağlık Değerlendirme Anketi ve  Ritchie artiküler indeksi değerlendirildi. Olguların hastalık aktivite skoru DAS-28 indeksi ile hesaplandı. İstatiksel analizde Graph Pad Prisma V3 paket programı kullanıldı. Verilerin değerlendirilmesinde tanımlayıcı istatiksel metodların (ortalama, standart sapma) yani değişkenlerin birbirleri ile ilişkilerini belirlemede Pearson Korelasyon testi kullanılmıştır.

Bulgular: Lomber KMY skoru ile DAS-28 ve HAQ, RAİ arasında kuvvetli korelasyon saptandı (p<0.001). Ayrıca Lomber total t skoru ile DAS-28 ve HAQ, RAİ arasında kuvvetli korelasyon saptandı (p<0.001) (tablo 3). Femur KMY skoru ve femur total t skoru ile DAS-28 ve HAQ, RAİ arasında herhangi bir korelasyon yoktu (p>0.05).

Sonuçlar: Çalışmanın sonucunda hastalık aktivite parametreleri ile KMY değerleri arasında kuvvetli bir ilişkinin olması özellikle enflamasyonun ağır seyrettiği ve tedaviye rağmen enflamasyonun baskılanamadığı hastalarda osteoporoz ve kırık riski açısından dikkatli olunması gerektiğini bildiririz.

 

Bone Mineral Density Correlation Between Disease Activity Scores In Patients With Rheumatoid Arthritis

 

Objective: In this study we researched for the relationship between  the disease activity scores and the bone mineral density in rheumatoid arthritis patients. 

 

Methods: 50 female patients who were diagnosed as RA according to the American College of Rheumatology (ACR) criteria were included for the study. The demographic characteristics, swollen and tender joint counts, patient and physician disease activity evaluation v(by visual analogue scale:VAS), laboratory data of the erythrocyte sedimentation rate and C-reactive protein and bone mineral density levels were recorded. The clinical parameters was assessed by the Health Assessment Questionnaire and Ritchie articular index. Disease activity scores were calculated by DAS-28 index. Graph Pad Prisma V3 statistical analysis software package was used for statistical analysis. Pearson's correlation test was used for the relationships between  the variables.

Results: RAI, HAQ and DAS-28 scores had a strong correlation with  lumbar BMD (p <0.001). In addition, RAI, HAQ and DAS-28 scores had a strong correlation with total lumbar t score as well (p <0.001) (table 3). There was no correlation between Femur BMD, total hip BMD t scores and DAS-2, HAQ and  RAI scores (p> 0.05).

 

 

Conclusion: We report that there is a strong relation between disease activity parameters and BMD levels in RA patients, and one should bear in mind that especially the patients resistant to the treatment have risk for osteoporosis and fracture. 

Anahtar Kelimeler

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Kaynakça

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