臺灣博碩士論文加值系統

目標: 探討臨床上已達DAS28 緩解之病患, 其超音波與軟骨代謝生物指標COMP與CPII2的變化。
方法: 從2016年六月自2017年二月, 在單一一家醫學中心, 共14位符合1987年美國風濕病醫學會診斷類風濕關節炎且超過3年之患者, 接受生物與非生物抗風濕藥物且臨床上維持Disease activity score 28 (DAS28)緩解超過一年,於第0, 3, 6個月接受定期超音波掃描28對關節, 同時檢測C-reactive protein (CRP), Erythrocyte sedimentation rate (ESR), Oligomertic matrix protein (COMP) 與 C-propeptide of type II collagen (CPII)。
結果: 14位病人共接受42次超音波檢查, 平均關節的Power Doppler Scale (PD) Score 為1.28分, Grey scale (GS) score 為1.9分。在28對關節中最常出現超音波異常的是手腕關節, 比率為52%, 其中超音波的PD score 與 COMP的變化有相關(P= 0.0277), 與CPII, CRP與ESR的變化則無顯著相關。

Objective: To evaluate the change of ultrasound and cartilage biomarker COMP and CPII among rheumatoid arthritis who were in DAS28 remission.
Method: From June 2016 to February 2017, total fourteen patients were diagnosed to have rheumatoid arthritis by fulfill 1987 American College of Rheumatology revised criteria and have disease duration over than three years in one single center.
These patients received biologic and non-biologic disease mod anti-rheumatic drug and all of them achieved DS28 remission for more than one year. Scheduled ultrasound examination of 28 pairs of joints and blood test including C-reactive protein (CRP), Erythrocyte sedimentation rate (ESR), Oligomertic matrix protein (COMP) and C-propeptide of type II collagen (CPII) at month 0, 3 and 6.
Results: 14 patients received totally 42 times of ultrasound examination. The average Power Doppler scale (PD) score: 1.28, Grey scale (GS) score: 1.9. The most common abnormal finding in ultrasound in these 28 pair joints was wrist joint, 52%. The ultrasound PD score have significant association with COMP (P=0.0277), no significant association with CPII, CRP and ESR.

第一章 緒論---------------------------------------------6

1.1. 類風濕關節炎的歷史背景---------------------------6
1.2. 類風濕關節炎的治療-------------------------------6
1.3. 類風濕關節炎疾病活性的評估-----------------------7
1.4. 類風濕關節炎的影像檢查---------------------------8
1.5. 軟骨代謝生物標記的意義---------------------------8

第二章 研究動機及研究目---------------------------------18

第三章 病人與研究方法-----------------------------------19

1.1.病人-------------------------------------------------19
1.2.研究設計---------------------------------------------19
1.3.超音波檢查-------------------------------------------19
1.4.軟骨代謝生物標記檢測---------------------------------20
1.5.統計軟體與分析方法-----------------------------------20

第四章 研究結果-----------------------------------------21

第五章 討論---------------------------------------------22

第六章 參考文獻-----------------------------------------23

附錄-----------------------------------------------------29

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