سرم با فعاليت آرتريت دوماتوييد CRP ارتباط غلظت

Correlation Between Serum CRP Levels and Disease Activity in Rheumatoid Arthritis

Objective: Rheumatoid arthritis (RA) is a disease with a progressive course. Continuous treatment is needed to supperes inflammatory reactions and disease activity (DA). At the present the adequacy of treatment is determined on the basis of clinical improvement and normalization of laboratory tests. Despite the wide use of CRP as a laboratory test in the follow-up of RA patients, itʹs usage as a paramenter of DA has not been investigated to determine the association between the serum CRP concentration and DA in RA. Materials and Methods: patients who fulfilled the ACR 1987 criteria were studied. Serum CRP concentration, ESR and DAS 28 (DAS) were determined at entry and studied patients were classified according to DA levels as high DA (DAS> 5.1); moderate DA (5.15DAS> 3.2), low DA, (3.2<_DAS>2.4) and disease remission (DAS?2.4). The mean CRP values were compared between groups with different DA levels. The relationship between serum CRP concentrations and DAS was assessed by correlation and regression analysis. Resulths: 100 consecutive patients (89 females, 11 males), with mean age of 51.5±14.5 years and disease duration of 64.5±70.7 months were studied. 50% of patients were using one or two disease modifying anti-rheumatic drugs and 88% of the studied patients had active disease at entry. There was a significant differences in serum CRP concentrations between the groups with different DA levels (p<0.016). There were also significant differences in serum CRP levels between patients with high and moderate DA (p= 0.045) as well as between patients with high DA and patients at remission (p=0.004). In regression analysis there was a positive linear relationship between the serum CRP and DAS (r=0.28,p =0.04), the regression coefficient after controlling the effects of age, sex, disease duration and rheumatoid factor was 0.01 (p= 0.04). For every one unit increase (1mg/l) of CRP cncentration, there was an inerease in DAS 28 by 1%. Conclusion: Regarding the findings of the present study, there is a relationship between serum CRP and DA in RA. The level of DA can be predicted on the basis of serum CRP concentration.