来源：风湿病与关节炎,2022,11（7）:12-17.

1382例类风湿关节炎患者Sharp评分与免疫炎症指标的相关性分析（临床研究）

孙艳秋¹，刘　健²，忻　凌²，文建庭¹，张先恒¹，陈晓露¹，周　琴¹，丁　香¹

　　【摘　要】目的：分析类风湿关节炎患者双手X线Sharp评分与临床免疫炎症指标的相关性，并探究Sharp评分的影响因素。方法：收集1382例类风湿关节炎住院患者资料，对所有患者进行双手X线检查并做Sharp评分，调取患者的一般资料及临床免疫炎症指标，比较不同组别患者的Sharp评分。运用Spearman分析及关联规则分析的方法研究Sharp评分与年龄、住院时间、红细胞沉降率（ESR）、C反应蛋白（CRP）、类风湿因子（RF）、免疫球蛋白A（IgA）、免疫球蛋白G（IgG）、免疫球蛋白M（IgM）、抗环瓜氨酸肽抗体（抗CCP抗体）的相关性。运用二元Logistic回归分析Sharp评分的影响因素。结果：不同年龄组、不同住院时间组患者的Sharp评分差异有统计学意义（P < 0.01）。ESR、CRP、RF、IgA、IgG、IgM升高组的Sharp评分较正常组或降低组均显著升高（P < 0.01或P < 0.05）。Spearman相关性分析表明，类风湿关节炎患者的Sharp评分与年龄、住院时间、CRP、RF、IgA、IgG、IgM呈正相关（P < 0.01或P < 0.05）。关联规则分析表明，类风湿关节炎患者Sharp评分（> 29分）与女性具有强关联，与ESR、RF、CRP、抗CCP抗体指标的升高具有强关联。二元Logistic回归分析表明，女性、年龄（> 60岁）、CRP升高、IgA升高是Sharp评分（> 29分）的危险因素（OR > 1，P < 0.01或P < 0.05）。结论：类风湿关节炎患者的Sharp评分与临床免疫炎症指标存在相关性，女性、高龄、CRP升高、IgA升高是Sharp评分（> 29分）的危险因素。

　　【关键词】　类风湿关节炎；Sharp评分；骨破坏；免疫炎症；危险因素

Correlation Analysis Between Sharp Score and Immune Inflammatory Index in 1382 Patients with Rheumatoid Arthritis

SUN Yan-qiu,LIU Jian,XIN Ling,WEN Jian-ting,ZHANG Xian-heng,CHEN Xiao-lu,ZHOU Qin,DING Xiang

　　【ABSTRACT】Objective:To analyze the correlation between the X-ray Sharp score of both hands and clinical immune inflammatory indicators in patients with rheumatoid arthritis,and to explore the influencing factors of sharp score.Methods:The data of 1382 hospitalized patients with rheumatoid arthritis were collected.All patients were examined by X-ray and Sharp score was made.The general data and clinical immune and inflammatory indicators of patients were retrieved,and the sharp scores of patients in different groups were compared.Spearman analysis and association rule analysis were used to study the correlation between Sharp score and age,length of hospitality,erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,rheumatoid factor（RF）,immunoglobulin A（IgA）,immunoglobulin G（IgG）,immunoglo-bulin M（IgM）,anti cyclic citrullinated peptide antibody（anti CCP antibody）.Binary Logistic regression was used to analyze the influencing factors of Sharp score.Results:The Sharp scores of patients in different age groups and different hospitalization time groups were statistically significant（P < 0.01）.The Sharp scores of groups with increased ESR,CRP,RF,IgA,IgG and IgM were significantly higher than those of the normal group or groups with above index decreased（P < 0.01 or P < 0.05）.Spearman correlation analysis showed that the Sharp score of patients with rheumatoid arthritis was positively correlated with age,length of stay,CRP,RF,IgA,IgG and IgM（P < 0.01 or P < 0.05）.Association rule analysis showed that the Sharp score（> 29）of patients with rheumatoid arthritis was strongly associated with women,and was strongly associated with the increase of ESR,RF,CRP and anti CCP antibody.Binary logistic regression analysis showed that female,age more than 60,elevated CRP and IgA were risk factors for Sharp score（> 29）（OR > 1,P < 0.01 or P < 0.05）.Conclusion:The Sharp score of patients with rheumatoid arthritis is correlated with clinical immune and inflammatory indicators.Female,old age,elevated CRP and IgA are the risk factors of Sharp score（> 29）.

　　【Keywords】 rheumatoid arthritis;Sharp score;bone destruction;immune inflammation;risk factors