摘要
目的分析类风湿关节炎（RA）患者血浆纤维蛋白原／纤维蛋白降解产物（FDP）、D-二聚体（DD）和纤维蛋白原（F异）水平，探讨纤溶活性增强与RA病情活动性的关系。方法活动性RA组50例，病情缓解RA组50例。应用血凝仪、特定蛋白仪等，采用免疫散射比浊法测FDP、DD和C反应蛋白（CRP），Clauss法测定Fg水平；光学毛细管法测红细胞沉降率（ESR）；免疫透射比浊法测类风湿因子（RF）IgG。采用两样本t检验、r检验、直线相关进行统计学分析。结果活动性RA组FDP，DD和Fg升高[（12．O±8-2）μg/ml，（3．1±3．1）斗咖l，（4．6±1．4）g／L]，与RA缓解组[（2．1±1．1）txg／ml，（0．4±O．4）μg／ml，（3．0±0．6）g／L]比较差异有统计学意义（D1．60，P〈0．05；;〉2．69，P〈O．01）。FDP，DD性别差异无统计学意义（t〈2．00，P〉0．05）；活动组与缓解组男性Fg均高于女性（t=2．19，2．38；尸〈0．05）。FDP与疾病活动指数（DAS28）呈直线正相关（栅48，P〈0．01），与EsR呈直线正相关（卸．28，P〈0．05）。DD与DAS28，ESR呈直线正相关（卸．69，0．52，P均〈0．01）。Fg与DAS28，ESR，CRP呈直线正相关（r=0．57，0．64，0．68，P均〈0．01）。FDP，DD，Fg与RF水平无直线相关（r=-0．07，0．06，-0．01，P均〉0．05）。FDP对活动性RA诊断的灵敏度94％、特异性100％、Kappa值0．94；DD为90％，86％，0．76；Fg为60％，88％，0．48。结论活动性RA患者FDP与DD升高，纤溶活性增强与病情活动性密切相关，FDP、DD升高可作为RA活动的判断依据。诊断活动性RA的准确性FDP〉CRP〉DD〉ESR〉Fg〉RF；RF对FDP和DD测定结果无影响。
Objective The plasma levels of fibrinogen degradation products （FDP）, Ddimer（DD） and fibrinogen （Fg） in patients with rheumatoid arthritis （RA） were tested and the relationship between the upregulated coagulation system and disease activity were explored. Methods Patients were divided into the active group and the remission group and 50 patients were included in each group. Hematological variables, including FDP, DD, Fg, and disease activity parameters including erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP） levels and rheumatoid factor （RF） titer were measured. Twosample ttest, linear correlation test and Chisquare test were used for data analysis by SPSS 11.0 software. Results Age and sex were comparable in the two groups （P〉0.05）. The FDP, DD and Fg were significantly higher in patients with active disease [（12.0±8.2） μg/ml, （3.1±3.1） μg/ml, （4.6±1.4） g/L] than those in patients with remission [（2.1±1.1） txg/ml, （0.4±0.4） txg/ml, （3.0±0.6） g/L, all P〈0.01]. There was no difference in gender distri bution in FDP and DD （P〉0.05）. However, Fg was significantly higher in men than that in women（P〈0.05）. FDP showed a significantly positive correlation with DAS28 （r=0.48, P〈0.01 ） and ESR（r=0.28, P〈0.05）. DD correlated positively and significantly with ESR and DAS28 （r=0.69, 0.52, all P〈0.01 ）. Fg was significantly positively correlated with DAS28, CRP and ESR （r=0.57, 0.64, 0.68, all P〈0.01）. FDP, DD and Fg werenot correlated with RF （r=-0.07, 0.06, -0.01, all P〉0.05）. Conclusion FDP and DD correlate well with disease activity and may be important disease activity parameters for RA.The rank of sensitivity of FDP, CRP, DD, ESR, Fg and RF for disease activity assessment of RA presents in a declined manner.
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2012年第4期247-250,共4页
Chinese Journal of Rheumatology
基金
上海市科委基础重点项目（08JCl406200）
关键词
关节炎
类风湿
纤维蛋白原降解物
D-二聚体
Arthritis, rheumatoid
Fibrin fibrinogen degradation products
D-dimer
