COMPARISON OF SERONEGATIVE AND SEROPOSITIVE RHEUMATOID ARTHRITIS WITH REGARD TO SOME CLINICAL CHARACTERISTICS

Broj: 1, 2009 Rubrika: Znanstveni rad Autori: Vjollca Sahatçiu-Meka, Remzi Izairi, Sylejman Rexhepi, Suzana Manxhuka-Kerliu

U našem istraživanju uspoređena je skupina seronegativnog i seropozitivnog reumatoidnog artritisa (RA) u odnosu na neke kliničke karakteristike. Ispitivana skupina je obuhvatila seronegativne bolesnike s titrom manjim od 1:64 određenim pomoću Waaler-Roseova testa, dok su kontrolnu činili seropozitivni bolesnici s titrom 1:64 ili višim. Svi ispitanici su pripadali II. i III. funkcionalnom razredu (ARA), bili životne dobi u rasponu 25-60 godina (Xb=49,96) s trajanjem bolesti 1-27 godina (Xb=6,41). U početku bolesti, najčešće zahvaćeni zglobovi su bili metakarpofalangealni (MCP) i proksimalni interfalangealni (PIP) zglobovi ruku, približno jednako zahvaćeni u odnosu na serološki status i spol. Tokom ispitivanja, seropozitivni bolesnici imali su znatno zahvaćenije periferne zglobove ruku i nogu, ali statistički značajno samo u slučaju rasprostranjenosti PIP ruku (χ2=15,63 p<0,01). Koljena, talokruralni zglobovi i laktovi su bili znatno više zahvaćeni u seropozitvnih bolesnika, dok humeroskapularni, koksofemoralni, sakroilijakalni i radiokarpalni zglobovi u seronegativnih, bez znatne statističke razlike u odnosu na serološki status. U odnosu na spol, relevantna statistička razlika je nađena u zahvaćenosti PIP ruku (χ2=9,96, p<0,01) i koljena (χ2=4,17, p<0,05) u seropozitivnih ženskih bolesnika, kao i kod zahvaćenosti PIP ruku (χ2=6,08, p<0,05) i cervikalnog dijela kralježnice (χ2=6,00, p<0,05) u seropozitivnih muških bolesnika. Kod metatarzofalangealnih (MTP) zglobova, PIP nogu, kao i kod drugih zglobova, nađene su određene razlike između skupina u pogledu spola, ali statistički neznačajne. U obje ispitivane skupine statistički značajno je bila zahvaćenost drugih (χ2=20,85, p<0,01) i trećih (χ2= 15,70, p<0,01) prstiju u razini PIP ruku, kao i trećeg prsta (χ2 =6,52, p<0,05) u razini MCP, ali statistički neznačajno u odnosu na serološki status i spol. Veliki broj bolesnika je imao 1-4 deformiteta. U seropozitivnih bolesnika su dominirale kontrakture koljena, laktova, kao i everzija stopala, a u seronegativnih bolesnika deformiteti u obliku labuđeg vrata. Nisu nađene statistički relevantne razlike u odnosu na serološki status i spol. Broj deformiteta se povećao s povećanjem prosječnog trajanja bolesti i ova razlika je izražena sa znatnom statističkom razlikom (t=5,92, p<0,01). Izračunavanjem linearne korelacije između ovih dviju pojava, nađena je pozitivna i visoka korelacija (r=0,49, p<0,01) u cjelini i po skupinama, ali bez znatne statističke razlike u odnosu na serološki status. Trajanje bolesti u odnosu na vrstu deformiteta između skupina bilo je različito. Znatne statističke razlike su nađene za deformitet “bottonhole” s dužim trajanjem bolesti u seropozitvnih bolesnika (t=2,10, p<0,05), i za fibularnu devijaciju u seronegativnih bolesnika (t=2,64, p<0,01).

The aim of this study is to establish a scientifi c comparative analysis between seronegative and seropositive rheumatoid arthritis (RA), with regard to some clinical characteristics. The studied group consisted of RA seronegative patients with titters lower then 1:64 defi ned by Rose-Waaler test, while the control group consisted of RA seropositive patients with titters of 1:64 or higher. Examinees all belonged to the 2nd and 3rd functional classes according to ARA criteria, were between 25-60 years of age (Xb=49.96), with disease duration between 1-27 years (Xbox=6.41). In the disease onset most frequently affected joints were metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint of the hands, almost equally represented with regard to sero-status and sex. During the examination seropositive patients showed a higher presence of inflamation of peripheral joints of hand and foot, but only the presence of PIP of the hands was statistically signifi cant (χ2=15.63, p<0.01). Knees, talocrural joints and elbows were more frequently affected in seropositive patients, whereas humeroscapular, coxofemoral and sacroiliacal joints were more frequently affected in seronegative patients, but without signifi cant statistical difference with regard to sero-status. The presence of affected PIP of the hands (χ2=9.96, p<0.01) and knees (χ2=4.17, p<0.05) with regard to sex was statistically significant in seropositive female patients, as well as the presence of atacked PIP of the hands (χ2=6.08, p<0.05), and cervical vertebrae (χ2=6.00, p<0.05) in seropositive male patients. There were some differences between groups with regard to sex in metatarsophalangeal joints (MTP), PIP of the foot, and other joints, but without any statistical significance. In both subsets statistically signifi cant domination was found in affected second (χ2=20.85, p<0.01) and third (χ= 15.70, p<0.01) fi ngers of the PIP level of hands and third fi nger (χ2=6.52, p<0.05) of the MCP level. The mentioned parameters did not show a significant statistical difference with regard to sero-status and sex. Majority of patients had 1-4 deformities. Seropositive group had prevalent knee contractures, e.g. the eversion of the foot, while seronegative group had more “swan neck” deformities. The mentioned parameters did not show a significant statistical difference with regard to sero status and sex. Longer duration of the disease resulted in an increased number of deformities, and this difference was statistically significant (t=5.92, p<0.01). Linear correlation between these two parameters resulted as high positive in general (r=0.49, p<0.01) and for groups separately, but without significant statistical difference with regard to sero-status. Duration of the disease with regard to the type of deformities was different in both subsets: in case of the longer duration of the disease “buttonhole” was prevalent with statistically significant difference in seropositive patients (t=2.10, p<0.05), whereas “fibular deviation” was prevalent in seronegative patients (t=2.64, p<0.01).

Broj posjeta: 3

Uredi