摘要
目的了解类风湿关节炎(RA)患者关节腔积液的特征,为该病的诊断与治疗提供实验室依据。方法回顾分析该院2016年1月至2020年12月170例明确诊断为RA患者的关节腔积液的一般性状、细胞学检查、生化、免疫指标,并比较患者关节腔积液与血清总蛋白、尿酸、类风湿因子水平,以及不同抗环瓜氨酸肽(CCP)抗体患者的关节腔积液与血清总蛋白、尿酸、类风湿因子水平。结果170例患者膝关节腔积液中白细胞计数23.0(13.3,35.5)×10^(9)/L,中性粒细胞百分比80.0(64.0,86.0)%,总蛋白41.5(35.8,46.8)g/L,尿酸244.5(189.3,297.0)μmol/L,类风湿因子172.2(65.4,377.6)U/L,部分患者关节腔积液中可检出Reiter细胞、狼疮细胞及类风湿细胞等病理细胞。关节腔积液中总蛋白水平低于血清,差异有统计学意义(P<0.05)。无论在关节腔积液还是血清中,抗CCP抗体阳性组的类风湿因子水平均高于抗CCP抗体阴性组,差异均有统计学意义(P<0.05)。结论RA患者关节腔积液以中性粒细胞为主的大量炎症细胞集聚,总蛋白、腺苷脱氨酶水平升高,而且抗CCP抗体阳性患者的关节腔积液及血清中类风湿因子水平较抗CCP抗体阴性者高。
Objective To understand the characteristics of in patients with rheumatoid arthritis(RA),and to provide laboratory evidence for the diagnosis and treatment of the disease.Methods The general characteristics,cytological examination,biochemical and immune indexes of the synovial fluid in 170 patients with RA from January 2016 to December 2020 were retrospectively analyzed,and the synovial fluid and serum levels of total protein,uric acid and rheumatoid factor were compared,as well as the synovial fluid and serum levels of total protein,uric acid and rheumatoid factor in patients with different anti-cyclic citrullinated peptide(CCP)antibodies were compared.Results In the synovial fluid of 170 patients,the white blood cell count was 23.0(13.3,35.5)×10^(9)/L,the percentage of neutrophils was 80.0(64.0,86.0)%,the total protein was 41.5(35.8,46.8)g/L,and the uric acid was 244.5(189.3,297.0)μmol/L,rheumatoid factor 172.2(65.4,377.6)U/L,pathological cells such as Reiter cells,lupus cells and rheumatoid cells were detected in the synovial fluid of some patients.The total protein level in the synovial fluid was lower than that in serum,and the difference was statistically significant(P<0.05).No matter in the synovial fluid or the serum,the rheumatoid factor level of the anti-CCP antibody positive group was higher than that of the anti-CCP antibody negative group,and the difference was statistically significant(P<0.05).Conclusion In the synovial fluid of patients with RA,a large number of inflammatory cells mainly neutrophils accumulate,the levels of total protein and adenosine deaminase are increased,and the levels of rheumatoid factor in the synovial fluid and serum of anti-CCP antibody-positive patients were higher than those of anti-CCP antibody-negative patients.
作者
庄丽花
杨清兰
饶华春
郭庆昕
许超尘
郑辉福
ZHUANG Lihua;YANG Qinglan;RAO Huachun;GUO Qingxin;XU Chaochen;ZHENG Huifu(Department of Clinical Laboratory,Quanzhou Orthopedic-traumatological Hospital,Quanzhou,Fujian 362000,China;Department of internal medicine,Quanzhou Orthopedic-traumatological Hospital,Quanzhou,Fujian 362000,China)
出处
《检验医学与临床》
CAS
2021年第18期2716-2718,共3页
Laboratory Medicine and Clinic
关键词
类风湿关节炎
关节腔积液
类风湿因子
抗环瓜氨酸肽抗体
rheumatoid arthritis
synovial fluid
rheumatoid factor,anti-cyclic citrullinated peptide antibody
