Artrite reumatóide inicial : estudo de coorte para avaliação de marcadores sorológicos de atividade, determinantes prognósticos funcionais e radiográficos
| Autor: | Mota, Licia Maria Henrique da |
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| Jazyk: | portugalština |
| Rok vydání: | 2009 |
| Předmět: | |
| Zdroj: | Repositório Institucional da UnBUniversidade de BrasíliaUNB. |
| Druh dokumentu: | Doctoral Thesis |
| Popis: | Tese (doutorado)—Universidade de Brasília, Faculdade de Medicina, 2009. Submitted by Allan Wanick Motta (allan_wanick@hotmail.com) on 2010-07-16T19:30:33Z No. of bitstreams: 1 2009_LiciaMariaHenriquedaMota.pdf: 5507539 bytes, checksum: a9fd68ce0cd195aed77c61da9b1421c5 (MD5) Approved for entry into archive by Lucila Saraiva(lucilasaraiva1@gmail.com) on 2010-07-19T14:11:05Z (GMT) No. of bitstreams: 1 2009_LiciaMariaHenriquedaMota.pdf: 5507539 bytes, checksum: a9fd68ce0cd195aed77c61da9b1421c5 (MD5) Made available in DSpace on 2010-07-19T14:11:05Z (GMT). No. of bitstreams: 1 2009_LiciaMariaHenriquedaMota.pdf: 5507539 bytes, checksum: a9fd68ce0cd195aed77c61da9b1421c5 (MD5) Previous issue date: 2009 Introdução: A associação entre marcadores sorológicos e escores de questionários de qualidade de vida, como o Health Assessment Questionnaire (HAQ) e o Medical Outcomes Study SF-36 Health Survey (SF – 36) com o desfecho da artrite reumatóide (AR) inicial é controversa. Objetivos: Avaliar prospectivamente uma coorte de pacientes com AR inicial (menos de 12 meses de sintomas), a fim de: 1) Caracterizar os aspectos demográficos, clínicos, sorológicos e radiográficos, além do padrão de respostas aos questionários de qualidade de vida HAQ e SF-36; 2) Determinar a possível associação entre marcadores sorológicos (fator reumatóide - FR, anticorpos anti-peptídeos citrulinados cíclicos -anti-CCP e anti-vimentina citrulinada -anti-Sa) com parâmetros de desfecho clínico, radiográfico e terapêutico; 3) Avaliar a correlação entre os escores do HAQ e SF-36, os marcadores sorológicos e desfechos da AR. Pacientes e métodos: Foram avaliados 65 pacientes com diagnóstico de AR inicial no momento do diagnóstico, 40 dos quais foram acompanhados por 3 anos, em uso de esquema terapêutico padronizado. Registrados dados demográficos, clínicos, DAS 28, realizadas sorologias (ELISA) para FR (IgM, IgG e IgA), anti-CCP (CCP2, CCP3 e CCP3.1) e anti-Sa, e aplicados os questionários HAQ e SF-36 na avaliação inicial, e aos 3, 6, 12, 18, 24 e 36 meses de acompanhamento. Radiografias de mãos e pés foram solicitadas na avaliação inicial, aos 12, 24 e 36 meses. Como desfechos de evolução da AR, considerou-se a ocorrência de erosões radiográficas, remissão (DAS 28 Introduction: The association between serological markers and scores of quality of life questionnaires such as the Health Assessment Questionnaire (HAQ) and Medical Outcomes Study SF-36 Health Survey (SF - 36) with the outcome of the early rheumatoid arthritis (ERA) is controversial. Objectives: To prospectively evaluate a cohort of patients with ERA (less than 12 months of symptoms) in order to: 1) Describe the demographic, clinical, serological and radiographic aspects, and the pattern of responses to quality of life questionnaires HAQ and SF-36, 2) Determine the possible association between serological markers (rheumatoid factor - RF, anti-cyclic citrullinated peptide antibodies anti-CCP, and citrullinated anti-vimentin -anti-Sa) with parameters of clinical, radiographic and therapeutic outcome; 3) Evaluate the correlation between HAQ and SF-36 scores, serological markers and RA outcomes. Patients and methods: Sixty-five patients diagnosed with early RA at the time of diagnosis were evaluated, 40 of them were followed for 3 years, in use of standardized therapeutic treatment. Demographic and clinical data were recorded, DAS 28, as well as serology tests (ELISA) for RF (IgM, IgG and IgA), anti-CCP (CCP2, CCP3 and CCP3.1) and anti-Sa, with the application of HAQ and SF-36 questionnaires in the initial evaluation and at 3, 6, 12, 18, 24 and 36 months of follow-up. Hands and feet radiographs were requested in the initial evaluation, and at 12, 24 and 36 months of follow-up. As outcomes of the RA development, the occurrence of radiographic erosions, remission (DAS 28 |
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