脊柱关节炎患者D-二聚体和纤维蛋白原检测临床意义初探

Detection and clinical significance of blood of D-Dimer and fibrinogen in spondyloarthritis

目的探讨检测D-二聚体和纤维蛋白原(Fib)在脊柱关节炎(SpA)患者中的临床意义。方法比较50例SpA、50例类风湿关节炎(RA)和50例SLE患者血中D-二聚体和Fib水平。并研究其与患者总体评分(PGS)、医生总体评分(DGS)、ESR、CRP、血小板、铁蛋白、HLA-B27等指标的关系。结果 SpA组、RA组、SLE组的血D-二聚体水平分别为(535±748)、(3 477±4 808)和(1 285±2 131)μg/L,SpA组血D-二聚体水平低于RA组和SLE组(P<0.05)。SpA组血Fib水平与RA组和SLE组比较差异无统计学意义。在SpA患者中,D-二聚体和Fib升高组的PGS和DGS均高于正常组患者(P<0.05)。D-二聚体升高组ESR、CRP和铁蛋白水平均高于D-二聚体水平正常组患者(P<0.05)。Fib升高组ESR、CRP和铁蛋白水平均高于Fib水平正常组患者(P<0.05)。D-二聚体和Fib与ESR、CRP、DGS具有相关性。D-二聚体水平与PGS具有相关性。结论SpA患者血中D-二聚体和Fib水平均有升高,且与疾病活动度密切相关。凝血-纤溶系统激活可能在SpA的病情发展和病理过程中发挥作用。

Objective To detect the clinical significance of D-Dimer and fibrinogen in the blood of spondyloarthritis （SpA） patients. Methods D-Dimer and fibrinogen of blood were detected among 50 patients with SpA, rheumatoid arthritis （RA）, and systemic lupus erythematosus （SLE）. further to investigate the re-lationship of other factors, such as patient global score （PGS） , doctor global score （DGS）, erythrocyte sedi-mentation rate （ESR）, C-reactvie protein （CRP）, platelet （PLT）, serum ferritin （SF）, and Human Leuco- cyte Antigen-B27 （ HLA-B27 ）. Results The titer of D-Dimer in SpA was significantly lower than that of the RA and SLE group [ （535 ± 748 ）, （3477 ± 4808 ） and （ 1285 ± 2131 ） μg/L respectively, P 〈 0. 05 ]. The level of fibrinogen in three groups was no significant difference. PGS and DGS was higher in SpA patients with positive D-Dimer and fibrinogen than those with control group （ P 〈 0. 05 ）. The values of ESR, CRP and SF in SpA patients with positive D-Dimer and fibrinogen were significantly higher than those in patients with control group. There was positive correlation between D-Dimer and fibrinogen and ESR （ r = 0. 37 and 0. 55 respec- tively, P 〈 0. 01 ）, CRP （ r = 0. 54 and 0. 54 respectively, P 〈 0. 01 ）, and DGS （ r = 0. 13 and 0. 19 respec-tively, P 〈 0. 01 ）. D-Dimer had positive correlation with PGS （r = 0. 15, P 〈 0. 01 ）. Conclusion The level of D-Dimer and fibrinogen in the blood of SpA patients in increased, and is positively correlated with disease activities. The results indicated that the activation of coagulation-fibrinolytic system may play a role in the path- ogenesis of SpA.