类风湿性关节炎患者D-二聚体测定及其临床意义

目的：了解类风湿性关节炎患者血浆D-二聚体水平及其临床意义。方法采用免疫比浊法测定56例类风湿性关节炎患者血浆D-二聚体水平,按其数值将患者分为D-二聚体水平升高组和正常组,分别比较两组间患者晨僵时间、关节肿胀数、关节疼痛数、红细胞沉降率、C反应蛋白、类风湿因子、抗CCP抗体及关节外表现,并通过Spearman相关分析,分析D-二聚体与疾病活动度（DAS28评分）的相关性。结果D-二聚体水平增高组患者ESR、CRP、肿胀关节侧数均高于D-二聚体水平正常组,且D-二聚体水平增高组患者关节外症状的发生率（血管炎、转氨酶升高、贫血）也高于对照组,D-二聚体水平与DAS28评分呈正相关。结论血浆D-二聚体水平与类风湿性关节炎病情活动相关,临床可作为类风湿性关节炎病情活动的依据。

The level of plasma D-dimer and its clinical significance in patients with rheumatoid arthritis

Objective To study the clinical significance of plasma D-dimer in patients with rheumatoid arthritis. Methods Patients were divided into the active group and compare group by the level of plasma D-dimer.The following clinical and laboratory data were collected：disease activity index DAS28,rhrumatoid factor（RF）,erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,stiff time,the number of joints with pain or swelling. Result Compared with control group, the group of hige level of plasma D-dimer had higher level of ESR、CRP、and the number of joints with swelling . The incidence of anemia、vasculitis、liver damage were higher in group with high level of plasma D-dimer. The level of plasma D-dimer showed a significantly positive corelation with DAS28. Conclusion Plasma D-dimer correlate well with disease activity.