活动期类风湿关节炎患者血小板增高的临床意义

目的:探讨外周血血小板(PLT)增高与类风湿关节炎(RA)病情的关系。方法:将139例RA患者根据其外周血PLT计数结果分为PLT正常组和PLT增高组,比较两组的临床表现及相关实验室指标有无差异,并将PLT计数结果与相关实验室检查指标进行相关分析。结果:两组关节肿胀数、关节压痛数以及平均红细胞沉降率(ESR)、C反应蛋白(CRP)和类风湿因子(RF)滴度等差异均有统计学意义(P<0.01),处于活动期的RA患者PLT计数与ESR、CRP和RF滴度呈正相关关系(r分别为0.41、0.24、0.17,P<0.05~P<0.01)。PLT计数>450×109/L的RA患者血清平均抗环瓜氨酸多肽抗体(抗CCP抗体)水平为(199±96)u/ml,而其他RA患者血清抗CCP抗体水平为(118±108)u/ml,差异有统计学意义(P<0.01);PLT计数>450×109/L的RA患者关节X线有Ⅱ期以上病变者占46.2%,而其他RA患者仅为19.6%,差异无统计学意义(P>0.05)。结论:外周血PLT增高与RA的病情活动性有一定关系,PLT计数可以作为评价RA病情活动简便有效的指标之一。

Role of high-platelets in active rheumatoid arthritis

Objective ：To investigate the relationship between increased peripheral blood platelets and rheumatoid arthritis （RA）. Methods： One hundred and thirty-nine patients with RA were divided into normal platelet group and high platelet group according to the platelet count, and the difference between the clinical manifestation and laboratory examination was compared. At the same time, correlated analysis was carried out between the platelet count and the laboratory examination. Results：There was significant difference in swollen joint count, tender joint count, average erythrocyte sedimentation rate （ ESR）, C-reactive protein （CRP） and rheumatoid factor （RF） titer between the two groups （ P 〈 0. 01 ）. The platelet count of RA patients was positively correlated with ESR, CRP and RF titer （ r = 0. 41,0. 24,0.17, respectively, P 〈 0. 05 to P 〈 0.01 ）. The average level of anti-cyclic citrullinated peptide （CCP） antibody in the RA patients with platelet count over 450 × 10^9/L was （ 199 ± 96 ） u/ml, while the average level of anti-CCP in the other RA patients was（ 118 ± 108 ） u/ml. The former was significantly higher （ P 〈 0.01 ） ; X-ray It joints lesion was observed in more than 46.2% of the patients with platelet count over 450 × 10^9/L RA,while it was 19.6% in the other group. The difference was not significant （P 〉 0.05 ）. Conclusions：Increased peripheral blood platelet count has some correlation with the activity of RA disease. Platelet count can be used as a simple and effective index to evaluate the activity of RA disease.