DOI: 10.5593/SGEM2016/B61/S25.102


M.Fortofoiu, M.C.Fortofoiu
Wednesday 7 September 2016 by Libadmin2016

References: 16th International Multidisciplinary Scientific GeoConference SGEM 2016, www.sgem.org, SGEM2016 Conference Proceedings, ISBN 978-619-7105-68-1 / ISSN 1314-2704, June 28 - July 6, 2016, Book6 Vol. 1, 767-774 pp


Introduction: Rheumatoid arthritis is an autoimmune disease of the connective tissue, of unknown etiology, characterized by symmetrical synovitis generating erosive joint damage and sometimes multi-systemic severe impairment, having chronic fluctuating trend if untreated, causes progressive joint damage with consecutive permanent deformation joints accompanied by motor deficits and reduce life expectancy.
Objective: The study has as objective the determination of a markers or the which parameters through correlation with the radiologic modifications supervened on one year of his evolution permits a how much appreciation the maul corrects the subsequent evolutions of rheumatoid arthritis.
Patients and methods: The study was accomplished on a number of 100 patients diagnose with rheumatoid arthritis on the basis of revised 2010 rheumatoid arthritis criteria. The patients enrolled in study were within maximum two years after onset of diseases. The parameters follow to inclusion in study was: age, sex, profession, environment, HLA genotype, age at diagnosis, onset modality, pain, morning stiffness, tender and swollen joint count, disease activity score (DAS28), functional status and quality of life (HAQ), inflammatory parameters (ESR, CRP, fibrinogen), immunological parameters (rheumatoid factor, CIC, C3, pro-inflammatory citokines-IL-1, IL-6, TNF-?), radiologic modified Sharp score (SENS method). Clinical, biological and imagistic assessment were done at 3, 6, 9 and 12 months. The main outcomes radiological damages defined according to the modified Sharp score. Statistical methods used in this study was SPSS 12 with the following: descriptive, correlation, linear regression and general linear model univariate.
Results: Duration of disease was minimum 0.75 months and maximum 24, mean 10.7 months a standard deviation was 6.51. The maximum value of painful joints was 18 and the maxim 8 swollen joints. The minimum value of painful joints was 4 and minimum value of swollen joints was 1. Determination of radiologic scores SHARP modify through SENS method emphasized a minimum value of 1 and the value a maximum of 23 with the mean of 11.90 and standard deviation of 4.82. The values rheumatoid factors IgM was correlated high significant to 6 months and to 12 months and significant to 6 months and 9 months. Significant correlation they emphasized between the values IgM to 6 months and the values IgM at enrolled and to 3 months. The values rheumatoid factors IgG to 12 months was correlated significantly with the values determinate to 3 months (p <0.05) and high significant with values at 6 months (p<0.01). High significant correlation was between the score Sharp modifies to inclusion in study and next the parameters: the age and duration of disease. After 1 year of evolution hypodermic nodule were emphasized to 24 of cases, ocular manifestation to 4 cases, the pulmonary and renal dysfunction were sit for 6 the cases and the cardiac affectation to 4 cases.
Conclusions: The factors of direct aggressiveness emphasis of this study are: duration of disease, the score HAQ, fibrinogen, protein C reactive, the rheumatoid factor, interleukin 6, TNF-α and the radiologic score to beginning again among indirect factor are the age, the score of activity of disease (DAS), painful joints, CIC, interleukin. We were not evidence significant connections which permits the appreciation degrees of involve the professions, ESR and fraction C3 of complements in evolution rheumatoid arthritis for the studied group.

Keywords: rheumatoid arthritis, SHARP score, prediction, evolution