D-二聚体、纤维蛋白原在类风湿性关节炎患者外周血中的含量测定  

Changes of D-dimer and fibrinogen levels in peripheral blood of patients with rheumatoid arthritis

作　　者：黄菊[1] 王宙政[1] 叶俏[1] 韩艳霞[1] 

机构地区：[1]浙江省嘉兴市第二医院血液风湿免疫科,314000

出　　处：《中华全科医学》2014年第3期401-402,共2页Chinese Journal of General Practice

摘　　要：目的通过检测D-二聚体、纤维蛋白原在类风湿性关节炎(RA)中含量的变化,同时测定超敏C反应蛋白、红细胞沉降率及类风湿因子等指标,判断D-二聚体、纤维蛋白原与病情活动度的关系,以指导临床治疗。方法RA组50例、健康对照组30例、骨关节炎组30例,分别测定3组上述指标的变化,采用χ2检验、各组之间进行LSD-t检验、直线相关统计学分析。结果 RA组中D-二聚体、纤维蛋白原、超敏C反应蛋白、红细胞沉降率及类风湿因子水平均明显升高,RA治疗前后相比D-二聚体、纤维蛋白原、超敏C反应蛋白变化明显,而红细胞沉降率及类风湿因子水平变化不明显,提示D-二聚体、纤维蛋白原、超敏C反应蛋白对RA病情活动度的判断上更为敏感,且D-二聚体、纤维蛋白原均与超敏C反应蛋白、红细胞沉降率呈正相关,与类风湿性因子无相关性。结论RA患者中D-二聚体、纤维蛋白原水平升高,可与超敏C反应蛋白、红细胞沉降率等指标一起判断疾病活动度,上述指标联合检测有助于与其他类型关节炎相鉴别,同时为RA患者进行改善微循环治疗提供有力依据。Objective To detect the change of D-dimer, fibrinogen, C-reactive protein （ CRP）, erythrocyte sedimentation rate（ESR） ,rheumatoid factor（RF） levels in patients with rheumatoid arthritis （RA）, and evaluate the relationship between the levels of D-dimer and fibrinogen to the activity of RA. Methods RA group included 50 patients with rheumatoid arthritis,control group included 30 normal subjects, and osteoarthritis group included 30 patients with osteoarthritis. The levels of D-dimer,fibrinogen, CRP, ESR and RF were tested in all three groups. LSD-T test,linear correlation test and Chiquare test were employed to analyze data with SPSS 18.0 software. Results In the RA group, the levels of D-dimer, fibrinogen, CRP, ESR and RF were higher than those in the other two groups. The changes of D-dimer,fibrinogen and CRP were more significant after the treatment. D-dimer, fibrinogen and CRP were more sensitive to decide of the activity of RA; D-dimer and fibrinogen were positively correlated with CRP and ESR,but not with RF. Conclusion The increased D-dimer and fibrinogen levels may be adopt with ESR and CRP in the decision of the activity of RA ; the combining detection of the above parameters can offer a method to differentiate RA from the other arthritis, also it can offer instance for the improvement of the microcirculation.

关 键 词：D-二聚体 纤维蛋白原 超敏C反应蛋白 红细胞沉降率 类风湿因子 类风湿性关节炎 骨性关节炎 

分 类 号：R593.22[医药卫生—内科学] R446.11[医药卫生—临床医学]