背景:在银屑病关节炎(PsA)的评估和结果方面,认为这是一个至关重要的方面。肌肉骨骼超声(MSUS)是准确检测附着点炎的关键工具。最近的研究集中在确定用于检测和监测牛皮癣病的简单生物标志物。红细胞分布宽度(RDW),平均血小板体积(MPV),中性粒细胞/淋巴细胞比率(NLR)是全血细胞计数(CBC)的组成部分,并且是各种风湿性疾病中可靠的生物炎症标志物。
目的:要测量MPV,RDW,和NLR在牛皮癣性附着物病中的应用,并确定它们与疾病活动和MSUS发现的关系。
方法:根据CASPAR标准,本研究集中于30名银屑病关节炎(PsA)患者,以及20个对照对象。使用利兹端炎指数(LEI)进行临床评估。计算改良的银屑病关节炎疾病活动指数(DAPSA28),和RDW,MPV,NLR,CRP,测量ESR。根据OMERACT定义,使用普通X线照相术和MSUS对LEI中的每个发生进行放射学评估。
结果:临床压痛,平原X线照相术上存在附生体,和MSUS在设计站点的发现(每个p<0.001)。银屑病患者的RDW和MPV水平高于对照组(分别为p<0.001和0.01),两组NLR无显著差异(p=0.189)。RDW和MPV水平与DAPSA28评分呈正相关。
结论:通过将RDW和MPV视为可靠指标,并使用MSUS指数筛查银屑病附膜病,可以改善PsA疾病活动性的监测。关键点•临床识别PsA患者的附着点炎可能具有挑战性。成像MSUS指数有望进行客观分析,但在临床试验和日常实践中使用哪些指数尚未达成共识。•牛皮癣病患者的RDW和MPV水平较高,与DAPSA28评分呈正相关。•RDW和MPV可以被认为是通过MSUS评分改善的银屑病附膜病筛查。
BACKGROUND: Enthesopathy is considered a crucial aspect of assessment and outcome in psoriatic arthritis (PsA). Musculoskeletal ultrasound (MSUS) is a critical tool for accurately detecting enthesitis. Recent research focuses on identifying simple biomarkers for detecting and monitoring psoriatic enthesopathy. Red cell distribution width (
RDW), mean platelet volume (MPV), and neutrophil/lymphocyte ratio (NLR) are components of a complete blood count (CBC) and are reliable bio-inflammatory markers in various rheumatic diseases.
OBJECTIVE: To measure MPV, RDW, and NLR in psoriatic enthesopathy and determine their relationship to disease activity and MSUS findings.
METHODS: This study focused on 30 people with psoriatic arthritis (PsA) as per CASPAR criteria, along with 20 control subjects. Enthesopathy was evaluated clinically using the Leeds Enthesitis Index (LEI). The modified Disease Activity Index of Psoriatic Arthritis (DAPSA28) was calculated, and
RDW, MPV, NLR, CRP, and ESR were measured. Each enthesis in LEI was radiologically assessed using plain radiography and MSUS according to OMERACT definitions.
RESULTS: There was a significant relationship between clinical tenderness, the presence of enthesophytes on plain radiography, and MSUS findings at entheses sites (p < 0.001 for each). Psoriatic patients had higher levels of
RDW and MPV (p < 0.001 and 0.01, respectively) than controls, with no significant differences in NLR (p = 0.189) between the two groups.
RDW and MPV levels were positively correlated with the DAPSA28 score.
CONCLUSIONS: Monitoring PsA disease activity can be improved by considering
RDW and MPV as reliable indicators and using them to screen for psoriatic enthesopathy with MSUS indices. Key points • Clinically identifying enthesitis in patients with PsA can be challenging. Imaging MSUS indices hold promise for objective analysis, but there is no consensus on which indices to use in clinical trials and daily practice. • Patients with psoriatic enthesopathy have higher RDW and MPV levels, which are positively correlated with DAPSA28 score. • RDW and MPV can be considered in the turn of improved screening of psoriatic enthesopathy with MSUS scores.