D-二聚体及纤维蛋白原水平在类风湿关节炎中的临床意义

摘要

目的 了解类风湿关节炎(RA)患者血浆D-二聚体(DD)和纤维蛋白原(FIB)的水平及其与RA病情活动指标的关系.方法 检测RA患者及健康对照者血浆DD及FIB水平,分析RA血浆DD和FIB与血沉(ESR)、C反应蛋白(CRP)、血小板(PLT)、疾病活动度评分(DAS28)及血红蛋白(Hb)的相关性.结果 RA患者血浆DD水平[(364±325 )μg/L]高于健康对照者[ (99+91)μg/L] (P＜ 0.01);RA患者血浆FIB水平[(3.83±0.78) g/L]高于健康对照者[(2.43±0.63)g/L] (P＜ 0.01).RA患者血浆DD与FIB水平显著相关(r=0.55,P＜0.01),且二者分别与ESR(r=0.481,r=O.572;P＜ 0.01)、CRP(r=0.653,r =0.738;P＜0.01)、DAS28(r =0.494,r =0.441;P＜ 0.01)、PLT(r=0.611,r =0.461;P＜0.01)呈显著正相关,与Hb呈显著负相关(r=-0.35,r =-0.371;P＜ 0.01).结论 RA患者血浆DD升高并不必然提示血栓形成,血浆DD及FIB可能成为判断RA病情活动的参考指标.%Objective To investigate the plasm levels of D-dimer (DD) and fibrinogen (FIB) in patients with rheumatoid arthritis(RA) and analyze the correlation between DD.FIB and the activity of RA. Methods 69 patients with RA and 20 healthy controls were selected. The plasm DD and FIB levels of the two groups were detected. The correlation between plasm DD and FIB was analyzed.The correlations between DD and ESR,CRP,DAS28,PLT,HB were analyzed,the correlations between FIB and ESR,CRP,DAS28,PLT,HB was also analyzed. Results The plasm level of DD [ (364±325) μg/L ] in RA patients was higher than that of the healthy controls [ (99±91 ) μg/L, P < 0.01) ].The plasm level of FIB [ (3.83 ±0.78 )g/L]in RA patients was higher than that of the healthy controls [ (2.43±0.63 )g/L,P < 0.01). In the patients with RA,the plasm level of DD was obviously related to that of FIB(r =0.55,P < 0.01),and the plasm levels of DD and FIB were obviously related to ESR(r =0.481,r=0.572;P< 0.01 ),CRP(r =0.653,r =0.738;P< 0.01 ),DAS28(r =0.494,r =0.441 ;P< 0.01), and PLT (r =0.611,r =0.461,P< 0.01),and was negatively related to Hb(r =-0.35,r =-0.371 ;P< 0.01). Conclusion The plasm levels of DD and FIB elevated in the patients with RA, and the elevation could not identify thrombosis. DD and FIB might be used to judge the activity of RA.