Ankilozan Spondilitli Hastalarda Akut Faz Reaktanlarının Değerlendirilmesi

Öz

Amaç: Ankilozan spondilit (AS) hastalarının tanı ve takipteki yüksek akut faz reaktanları (AFR) düzeylerini belirlemek ve hastaların yüksek AFR düzeyleri ile hastalık aktivite düzeyleri ve klinik özellikleri arasındaki ilişkiyi araştırmak. Gereç ve Yöntem: Modifiye 1984 New York kriterlerine göre AS tanısı alan ve üniversite romatoloji kliniğinde takip edilen 948 hasta bu çalışmaya dahil edildi. Tüm ziyaretlerdeki hastaların eritrosit sedimantasyon hızı (ESH) ve C-reaktif protein (CRP) seviyeleri kayıt defteri ve hastanenin veri tabanı aracılığıyla geriye dönük olarak incelendi. Bulgular: İlk ziyarette, sırasıyla 626 (%68,5) ve 578 (%64,6) hastada yüksek CRP ve ESH seviyeleri gözlendi. Takip sırasında hastaların %84,6'sında yüksek CRP ve %69,5'inde yüksek ESH vardı, ancak hastaların %10'unda AFR hiç yükselmedi. ESH ile CRP arasında iyi bir korelasyon vardı (r=0,666 , p=0,000). İlk ziyarette CRP ile BASDAI (r=0,81, p=0,23) veya ASDAS (r=0,468 , p=0,000) arasında ESH ve BASDAI (r=0,111 , p=0,02) veya ASDAS ile karşılaştırıldığında daha iyi bir korelasyon gözlendi r=0,334, p=0,000). BASDAI ile karşılaştırıldığında, ESH (p=0,00) veya CRP (çok yüksek hastalık aktivitesi-p=0,000, inaktif hastalık-p=0,001) olan ASDAS, hastanın aktivitesini inaktif ve çok yüksek düzeyde şiddetli hastalık olarak değerlendirmede daha iyi performans gösterdi. Sonuç: Sonuçlarımız, AS hastalarında yüksek düzeyde akut faz reaktanlarının nadir olmadığını gösterdi. AFR, AS'nin değerlendirilmesinde ve/veya tedaviye yanıtta en önemli laboratuvar diagnostiği olarak düşünülmelidir.

Anahtar Kelimeler

• Ankilozan spondilit
• akut faz reaktanı
• eritrosit sedimantasyon hızı
• C-reaktif protein
• hastalık aktivite indeksi

Evaluation of Acute Phase Reactants in Patients with Ankylosing Spondylitis

Öz

Objective: To determine the high levels of acute phase reactants (APR) of ankylosing spondylitis (AS) patients at diagnosis and follow-up, and to investigate the relationship between patients’ high levels of APR and patients’ disease activity levels and clinical characteristics. Material and Methods : 948 patients who were diagnosed with AS according to the modified 1984 New York criteria and followed-up at the university rheumatology clinic were included in this study. The patients’ erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels across all visits were retrospectively reviewed through the registry and the hospital’s database. Results: At first visit, high levels of CRP and ESR were observed in 626 (68.5%) and 578 (64.6%) patients respectively. During follow-up 84.6% of patients had high CRP and 69.5% patients had high ESR, however in 10% of patients APRs did not increase at all. There was good correlation between ESR and CRP (r=0.666, p=0.000). A better correlation was observed at first visit between CRP and BASDAI (r=0.81, p=0.23) or ASDAS (r=0.468, p=0.000) compared to ESR and BASDAI (r=0.111, p=0.02) or ASDAS (r=0.334, p=0.000). Compared to BASDAI, ASDAS with either ESR (p=0.00) or CRP (very high disease activity-p=0.000, inactive disease-p=0.001) had better performance in evaluating the activity of the patient in inactive and very high levels of severe disease. Conclusions: Our results showed, high levels of acute phase reactants is not rare in AS patients. APR should be considered the most significant laboratory diagnostics in the evaluation of AS and/or response to the treatment.

Anahtar Kelimeler

• Ankylosing spondylitis
• acute phase reactant
• erythrocyte sedimentation rate
• C-reactive protein
• disease activity index

Kaynakça

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