类风湿性关节炎患者血液学改变特点及其临床意义.docVIP

类风湿性关节炎患者血液学改变特点及其临床意义 　　作者：陶丽菊，王小超，陈诗强，揭旭日，陆翔 作者单位：右江民族医学院附属医院，广西，百色，533000 　　【摘要】 目的 探讨类风湿性关节炎(RA)患者血液学改变的特点及其临床意义。方法 对126例RA住院患者的血液常规和反映RA活动的血细胞沉降率(ESR)、类风湿因子(RF)、C反应蛋白(CRP)进行检测，当血红蛋白量(Hb)100g/L、白细胞计数(WBC)4.0×109/L或10×109/L、血小板计数(PLT)300×109/L或100×109/L为血液常规异常;无以上改变者为血液常规无异常。设无血液常规异常患者作为对照组，并将有血液常规异常组的反映RA活动的ESR增快、高滴度的RF、高CRP的百分率与对照组比较。结果 126例RA患者中，血液常规异常者96例，占76.19%，无血液常规异常者30例，占23.81%。在96例血液常规异常中，贫血患者82例，占85.42%，主要是慢性病贫血(ACD)，占贫血患者的63.41%(52/82)，其次为缺铁性贫血(IDA)和溶血性贫血(HA)，分别占24.39%(20/82)和7.31%(6/82);WBC计数下降49例次;PLT计数增高46例次，PLT计数下降15例次。血液常规异常组的ESR增快、高滴度的RF、CRP增高比例均明显高于对照组(P0.01或P0.05)。结论 RA患者大部分存在血液常规异常，贫血占第一位，主要是慢性病贫血，其次是WBC减少和PLT增高;血液常规异常的RA患者处于疾病活动期，病情较重，应积极治疗。 　　【关键词】 关节炎 类风湿 血液学试验 评价研究 　　The change patterns of hematology in patients with rheumatoid arthritis and its clinical significane 　　TAO Li-ju, WANG Xiao-chao, CEN Shi-qiang, JIE Xu-ri, LU Xiang 　　(Affiliated Hospital of Youjiang Medical College for Nationalities, Baise, Guangxi 533000, China) 　　Abstract: Objective To investigate the change patterns of hematology in patients with rheumatoid arthritis (RA) and its clinical significane. Methods 126 inpatients with RA enrolled in this study. Blood routine testing was performed and the rheumatic factors (RF) and c-reactive proteins (CRP) were measured. While Hb100g/L, WBC4.0×109/L or10×109/L, PLT300×109/L or 100×109/L, the indexes of blood routine were abnormal, indexes without the mentioned above changes were normal. Patients with normal indexes were assigned in the control group. A comparison of the incidences of accelerated ESR, high titer RF and high CRP were performed between the abnormal group and the control group. Results in 126 patients with RA, of 96 patients (76.19%) with abnormal indexes of blood routine testing, 30 patients (23.81%) without abnormal indexes. Of 96 patients with blood abnormal indexes, 82 patients (85.42%) had anemia, anemia of chronic disease (ACD) occupied 63.41%(52/82), the secondary was iron deficient a