关节液及血液相关指标在痛风性和类风湿关节炎中的诊断价值探讨  

Value of Joint Fluid and Blood-related Indicators in the Diagnosis of Gouty Arthritis and Rheumatoid Arthritis

作　　者：张静[1] 邹明[1] 池继敏 张峰[1] 张红梅[1] 

机构地区：[1]四川省骨科医院检验科,成都610041

出　　处：《华西医学》2016年第8期1376-1379,共4页West China Medical Journal

摘　　要：目的探讨痛风性关节炎和类风湿关节炎患者关节液和血液相关指标的变化,分析其临床意义。方法检测2014年1月-12月收治的75例痛风性关节炎患者和68例类风湿关节炎患者关节液常规指标,包括白细胞计数(WBC)、总蛋白(TP)、白蛋白(ALB)、葡萄糖(GLU)、尿酸(UA),血液指标包括免疫球蛋(Ig)G、Ig M、Ig A、补体C3、C4、类风湿因子(RF)、抗链球菌溶血素O(ASO)、C反应蛋白(CRP)。结果关节液指标中,TP、ALB水平在两组关节炎中无明显差异(P>0.05),WBC、GLU、UA、RF、ASO水平在两组关节炎中有明显差异(P<0.05);血液指标中,C4两组间无明显差异(P>0.05),两组间的Ig G、Ig M、Ig A、CRP、C3、UA、RF、ASO差异有统计学意义(P<0.05)。且ASO在两组疾病中关节液的检出水平均高于血液检出水平(P<0.05)。在两组疾病中UA在关节液中和血液中,差异均无统计学意义(P>0.05)。在痛风性关节炎中RF水平在关节液和血液中差异有统计学意义(P<0.05);类风湿关节炎中RF的血液检出水平和关节液检出水平,差异无统计学意义(P>0.05)。ASO在痛风性关节液的血液和关节液的阳性分别是38.7%和44.0%,在类风湿关节炎的血液中75.0%阳性,关节液中73.5%阳性;痛风性关节炎92.0%血液UA为阳性,80.0%关节液阳性,而类风湿性关节炎血液中UA阳性率为38.2%,关节液里32.4%阳性;血液中的RF在痛风性关节炎中血液仅33.3%,而关节液阳性率为40.0%,在类风湿关节炎中的阳性率是86.8%,关节液中的阳性率91.2%。结论两组疾病患者的关节液和血液指标都在发生改变,在疾病的诊断和疗效的观察中有一定的临床价值。Objective To discuss the changes of joint fluid and blood-related indexes in patients with gouty arthritis and rheumatoid arthritis, and to analyze the clinical significance of these changes. Methods Seventy-five patients with gouty arthritis and 68 with rheumatoid arthritis treated between January and December 2014 were included in our study. Their joint fluid-related indicators including white blood cell count （WBC）, total protein （TP）, albumin （ALB）, glucose （GLU）, and uric acid （UA）, and their blood indicators including immunoglobulin G （IgG）, immunoglobulin M （IgM）, immunoglobulin A （IgA）, C3 and C4, rheumatoid factor （RF）, anti-streptolysin O （ASO）, and c-reactive protein （CRP） were detected. Results For joint fluid-related indicators, TP and ALB levels were not significantly different between the two groups （P 〉 0.05）, while were significantly different （P 〈 0.05）; For blood indexes, C4 WBC, GLU, UA, RF and ASO between the two groups was not significantly different between the two groups （P 〉 0.05）, but IgG, IgM, IgA, CRP, C3, UA, RF and ASO were significantly different between the two groups （P 〈 0.05）. The detection rate of ASO from the joint fluid was significantly higher than that detected from the blood in both the two groups （P 〈 0.05）, while UA level was not significantly different between the joint fluid and the blood （P 〉 0.05）. In patients with rheumatoid arthritis, RF detection rate was not significantly different between the joint fluid and the blood （P 〉 0.05）, but it was significantly different for patients with gouty arthritis （P 〈 0.05）. The positive rate of ASO in the blood and joint fluid of patients with gouty arthritis was respectively 38.7% and 44.0%, and it was 75.0% and 73.5% for patients with rheumatoid arthritis. UA positive rate in the blood and joint fluid of patients with gouty arthritis was 92.0% and 80.0% respectively, while it was 38.2% and 32.4% for patients with rheumatoid arthritis.

关 键 词：痛风性关节炎 类风湿关节炎 关节液指标 血液指标 

分 类 号：R589.7[医药卫生—内分泌] R593.22[医药卫生—内科学] R446.1[医药卫生—临床医学]