类风湿性关节炎患者血液学改变特点及其临床意义

The change patterns of hematology in patients with rheumatoid arthritis and its clinical significane

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(P<0.01或P<0.05)。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。

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 Hb〈100g/L, WBC〈4.0×10^9/L ora10×10^9/L, PLT〉300 ×10^9/L, or 〈 100×10^9/L, the indexes of blood routine were abhormal, 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 anemia （IDA） and hemolytic anemia （HA）, with 24.39% （20/ 82） and 7.31% （6/82）, respectively. 49 patients with decreased WBC, 46 with increased PLT, 15 with decreased PLT. The abnormal blood group had accelerated ESR, high titer RF and the CRP increased significantly than the control group （ P 〈 0.01 or P 〈 0.05）. Conclusion Most patients with RF suffered abnormal indexes of blood routine testing, anemia is the major risk factor, ACD ranks the first, secondarily is decreased WBC and increased PLT; patients with abnormal indexes of blood routine testing were in an active stage, with severe condition, and should be treated promptly.