717例骨关节炎患者凝血指标变化及其与免疫、炎症、脂代谢指标的相关性分析  

Changes of coagulation indexes and correlation analysis between them,immunity indexes,inflammation indexes and lipid metabolism indexes in 717 cases of patients with osteoarthritis

作　　者：贺明玉 刘健[2] 忻凌[2] 韩馨悦 高金栋 张颖[1] HE Mingyu;LIU Jian;XIN Ling;HAN Xinyue;GAO Jindong;ZHANG Yin(College of TCM,Anhui University of Chinese Medicine,Hefei,Anhui,230038,China;Department of Rheumatology,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei,Anhui,233031,China)

机构地区：[1]安徽中医药大学中医学院,安徽合肥230038 [2]安徽中医药大学第一附属医院风湿科,安徽合肥233031

出　　处：《甘肃中医药大学学报》2021年第3期68-73,共6页Journal of Gansu University of Chinese Medicine

基　　金：国家自然科学基金面上基金项目(81973655);科技部国家重点研发计划中医药现代化研究重点专项(2018YFC1705204);安徽省名中医刘健工作室建设项目(中医药发展秘[2018]11号);安徽省重点研究与开发计划项目(201904a07020004);安徽现代中医内科应用基础与开发研究省级实验室建设项目(2016080503B041)。

摘　　要：目的研究骨关节炎(OA)患者凝血指标的变化,分析其与免疫、炎症及脂代谢指标的相关性。方法收集安徽中医药大学第一附属医院风湿科717例OA住院患者临床诊疗的病历资料,分析患者凝血指标的变化,并利用SPSS 23.0统计软件将其与年龄、病程及免疫、炎症、脂代谢等实验室指标进行相关性分析和Logistic回归分析,应用SPSS Clementine 17.0软件中的Aprior模块对所有指标进行关联分析。结果 OA患者凝血指标值分析结果显示:活化部分凝血酶原时间(APTT)降低者377例(占52.58%),凝血酶原时间(PT)降低者230例(占32.08%),凝血酶时间(TT)升高者55例(占7.67%),纤维蛋白原(FIB)升高者98例(占13.67%),血小板计数(PLT)升高者63例(占8.79%)。相关性分析结果显示:APTT与三酰甘油(TAG)、总胆固醇(TC)、补体3(C3)均呈负相关(P<0.05或P<0.01),与免疫球蛋白M(Ig M)、血沉(ESR)、超敏C反应蛋白(hs-CRP)均呈正相关(P<0.01);PT与TAG、TC均呈负相关(P<0.01),与ESR、hs-CRP、免疫球蛋白A(Ig A)、免疫球蛋白G(Ig G)均呈正相关(P<0.01);FIB与ESR、hs-CRP、Ig A、Ig G、C3、补体4(C4)均呈正相关(P<0.01);PLT与TC、ESR、hs-CRP、Ig A、Ig G、C3、C4均呈正相关(P<0.01)。Logistic回归分析结果显示:病程、TAG、C4是APTT降低的危险因素,ESR、TC是PT降低的危险因素,ESR、TAG、hs-CRP是FIB升高的危险因素,病程、ESR、Ig G、C3是PLT升高的危险因素。关联分析结果显示:设定最小置信度为70%,最小支持度为15%,提取与各项指标置信度、支持度较高的指标。与APTT、PT下降关联较高的指标均为C4,与FIB上升关联较高的指标为hs-CRP、ESR和C4。结论 OA患者存在高凝状态,主要表现在APTT、PT降低,FIB、TT、PLT升高,并与炎症、免疫及脂代谢指标密切相关;ESR、hs-CRP、Ig G、C3、C4、TC、TAG是OA高凝状态的危险因素。Objective To study the changes of coagulation indexes in patients with osteoarthritis( OA) and to analyze correlation between them,immunity indexes,inflammation indexes and lipid metabolism indexes in patients with OA. Methods Medical records of 717 cases of inpatients with OA in rheumatology department of the First Affiliated Hospital of Anhui University of Chinese Medicine were collected,the changes of coagulation indexes in patients with OA were analyzed,and the correlation analysis and Logistic regression analysis were carried out with age,course of disease,immunity,inflammation,lipid metabolism and other laboratory indexes by using SPSS 23.0 statistical software. The correlation analysis of all indexes was carried out by using Aprior module of SPSS Clementine 17.0 software. Results The results of coagulation indexes analysis showed that: 377 cases( accounted for52.58%) had decreased activated partial thromboplastin time( APTT),230 cases( accounted for 32.08%) had decreased prothrombin time( PT),55 cases( accounted for 7.67%) had increased thrombin time( TT),98 cases( accounted for 13.67%) had increased fibrinogen( FIB) and 63 cases( accounted for 8.79%) had increased platelet count( PLT). The results of correlation analysis showed that APTT was negatively correlated with triglyceride( TAG),total cholesterol( TC) and complement 3( C3)( P<0.05 or P<0.01),and positively correlated with immunoglobulin M( IgM),erythrocyte sedimentation rate( ESR) and high sensitivity C-reactive protein( hs-CRP)( P <0.01);PT was negatively correlated with TAG and TC( P <0.01),and positively correlated with ESR,hs-CRP,immunoglobulin A( IgA) and immunoglobulin G( IgG)( P < 0. 01);FIB was positively correlated with ESR,hs-CRP,IgA,IgG,C3 and complement 4( C4)( P < 0. 01);PLT was positively correlated with TC,ESR,hs-CRP,IgA,IgG,C3 and C4( P<0.01). Logistic regression analysis showed that the course of disease,TAG and C4 were risk factors of APTT decrease,ESR and TC were risk factors of PT decrease,ESR,TAG and hs-CRP were risk factors o

关 键 词：骨关节炎 高凝状态 凝血指标 免疫指标 脂代谢指标 相关性分析 

分 类 号：R684.3[医药卫生—骨科学]