D-二聚体检测在类风湿性关节炎中的临床应用价值

The Clinical Application Value of D-Dimer in Rheumatoid Arthritis

目的检测D-二聚体在类风湿性关节炎(RA)患者中的水平,了解其在RA中的临床应用价值。方法检测35(?)RA患者及30例健康人群中D-二聚体的水平,并了解其与类风湿因子(RF),血沉(ESR),C反应蛋白(CRP),血小板(PLT),抗环(?)氨酸肽抗体(抗CCP抗体)及疾病活动度(DSA28)的相关性。结果①血D-二聚体水平在RA患者中明显高于对照组(P<0.01)②相关性分析显示,D-二聚体水平与DAS28评分(r=0.462,P<0.01)、ESR(r=0.497,P<0.05)、RF(r=0.639,P<0.01)、CRP(=0.562,P<0.01)、PLT(r=0.371,P<0.05)具有相关性,与年龄及病程无明显相关性(P>0.05)。③D-二聚体在CCP阳性组与阴性组患者中无明显相关性(P>0.05)。结论 RA患者中D-二聚体水平明显升高,且与疾病活动相关,提示凝血-纤溶系统在R的发病机理及疾病转归中存在重要意义。

Objective To research the plasm level of D-Dimer in rheumatoid arthritis（RA） patients and to analyze the value of clinical application in RA. Methods Thirty-five patients with RA and 30 healthy controls were selected. D-Dimer of the two groups were de- tected. The correlations between D-Dimer and ESR, CRP, DAS28, PLT, RF and CCP were analyzed. The t-test and Spearman correlation were used for statistical analysis. Results The plasm level of D-Dimer in RA patients was higher than in the heahhy eontrnls （ P 〈 0.01 ）. The plasm level of DD was obviously related to ESR （ r = 0. 497,P 〈 0.05 ）, CRP（ r = 0. 562, P 〈 0.01 ）, DAS28 （ r = 0. 462, P 〈 0.01 ）, and PLT （r = 0. 371, P 〈 0.05 ）, and was negatively related to age （ r = 0. 217, P 〉 0.05 ） and disease duration （ r = 0. 156, P 〉 0.05 ）. The level of D- Dimer in the positive group and negative group of CCP had no significant difference （ P 〉 0.05 ）. Conclusion The plasm level of D-Dimer el- evates in the patients with RA ,and has positive correlation with disease activity. The research indicated that the coagulation-fibrinolytic system may have an important significance in the pathogenesis and prognosis of RA.