类风湿性关节炎患者血小板参数与病情活动相关性的探讨  

Platelet parameters and its correlation with disease activity of rheumatoid arthritis

作　　者：王宙政[1] 韩艳霞[1] 叶俏[1] 胡蓓莉[1] 陈丽花[1] 

机构地区：[1]嘉兴市第二医院血液风湿免疫科,314000

出　　处：《浙江医学》2015年第14期1238-1240,共3页Zhejiang Medical Journal

摘　　要：目的观察类风湿性关节炎(RA)患者血小板参数的变化及其与临床表现、病情活动性指标的相关性。方法比较100例RA活动期、37例缓解期和50例健康体检者(正常对照组)的血小板计数(PLT)、血小板压积(PCT)、血小板平均体积(MPV)、血小板分布宽度(PDW)的变化;分析RA活动期组患者血小板参数与临床表现(病程、晨僵时间、DAS28分值)的相关性;同时分析与其它实验室指标ESR、超敏C反应蛋白(hs-CRP)、类风湿因子(RF)、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、补体C3、补体C4、抗环瓜氨酸肽抗体(抗CCP抗体)的相关性。结果 RA活动组PLT、PCT水平均较RA缓解组和正常对照组明显升高(均P<0.01),RA缓解组和正常对照组间上述指标的差异均无统计学意义(均P>0.05);RA活动组的MPV水平均较RA缓解组和正常对照组降低(均P<0.05),RA缓解组和正常对照组的MPV水平无统计学意义(P>0.05);3组间PDW水平的差异均无统计学意义(均P>005)。PLT与晨僵时间、DAS28、IgG、ESR、hs-CRP、RF、抗CCP抗体呈正相关(P<0.05);PCT与晨僵时间、DAS28、ESR、hs-CRP、RF、抗CCP抗体呈正相关(P<0.05);PLT、PCT均与C3、C4无相关性(均P>005);MPV、PDW均与上述实验室指标无明显相关性(均P>0.05)。结论动态监测PLT、PCT等血小板参数指标对临床判断RA的疾病活动性、指导治疗及预后具有一定的价值。Objective To investigate platelet parameters in patients with rheumatoid arthritis （RA） and its correlation with clinical symptoms and disease activity. Methods One hundred and thirty seven RA patients, including 100 in active phase and 37 in remission phase, and 50 healthy subjects were enrolled in the study. The platelet parameters, including platelet count （PLT）, platelet hematocrit（PCT）, mean platelet volume（MPV）, platelet distribution width（PDW） of three groups were measured. The correlation of platelet parameters with clinical symptoms （ course of disease, duration of morning stiffness, DAS28） and laboratory results including erythroeyte sedimentation （ESR）, hypersensitivity C reactive protein （hs-CRP）, rheumatoid factor （RF）, im- munoglobulin G （IgG）, immunoglobulin A （IgA）, immunoglobulin M （IgM）, complementC3, C4and anti-cyclic citrullinated peptide antibody （anti-CCP） in RA patients at active phase was analyzed. Results The circulating levels of PLT and PCT were higher in active RA patients than those in remission RA group and normal control group （P〈0.01）; there was no significant difference be- tween remission RA group and normal control group（P 〉0.05）. The MPV was lower in active RA patients than that in remission RA group and normal control group（P〈0.05）, but there was no difference between remission RA group and control group（P 〉0.05）. There was no significant difference in PDW level among the three groups （P 〉0.05）.The total number of PLT was positively correlated with duration of morning stiffness, IgG, ESR, hsCRP, RF and anti-CCP. The quantity of PCT was positively correlated with duration of morning stiffness, ESR, hsCRP, RF and anti-CCP ; however, the quantity of PLT and PCT had no correlation with C3 and C4. The levels of MPV and PDW had no correlation with the clinical symptoms and laboratory results （P 〉0.05）. Conclusion The detection of PLT, PCT and other platelet parameters is of value to determine act

关 键 词：类风湿关节炎 血小板参数 病情活动性 

分 类 号：R593.22[医药卫生—内科学]