老年风湿性多肌痛患者血清纤维蛋白原水平变化及意义

Changes of serum fibrinogen in patients with polymyalgia rheumatica in senile patients and its significance

目的探讨血清纤维蛋白原与风湿性多肌痛(polymyalgia rheumatic,PMR)的相关性及临床意义。方法初诊为PMR患者60例,采用口服泼尼松15mg/d治疗4周,比较初诊与治疗4周患者血沉、C反应蛋白、纤维蛋白原水平及PMR活动度评分。结果治疗4周后患者血沉[(18.23±10.01)mm/h]、C反应蛋白[(5.76±2.66)mg/L]、纤维蛋白原[(2.85±0.95)g/L]水平和PMR活动度评分(0.93±0.41)均明显低于初诊时[(63.35±17.23)mm/h、(63.19±17.24)mg/L、(5.81±0.52)g/L和(23.18±4.43)](P<0.01);纤维蛋白原、血沉、C反应蛋白与PMR活动度评分均呈正相关(r=0.956,P=0.000;r=0.903,P=0.001;r=0.937,P=0.000);纤维蛋白原判定PMR活动度的AUC为0.959,血沉为0.819,C反应蛋白为0.910。结论血清纤维蛋白原水平与PMR患者病情活动度密切相关,可反映PMR患者病情活动情况。

Objective To investigate the correlation between serum fibrinogen and polymyalgia rheumatica （PMR） in senile patients and its clinical significance. Methods Sixty patients with initially diagnosed PMR received oral administration of 15 mg/d prednisone for 4 weeks. The erythrocyte sedimentation rate （ESR）, the levels of C-reactive protein （CRP） and fibrinogen, and PMR activity score （PMR-AS） after 4-week treatment were compared with those at initial diagnosis. Results The serum ESR （（18.23±10.01） mm/h）, CRP （（5.76±2.66） mg/L）, fibrinogen （（2.85± 0.95） g/L） and PMR-AS （0.93 ± 0.41） after 4-week treatment were significantly lower than those at initial diagnosis （（63.35±17. 23） ram/h, （63. 19±17. 24） rag/L, （5. 81±0. 52） g/L, 23. 18,1,4. 43） （P〈0.01）. The serum fibrinogen, ESR and CRP were positively correlated with PMR-AS （r=0. 956, P=0. 000; r=0. 903, P=0. 001; r= 0. 937, P=0. 000）. AUC of fibrinogen for PMR was 0. 959, of ESR for PMR was 0. 819, and of CRP for PMR was 0. 910. Conelusion The serum fibrinogen level is closely correlated with the activity of PMR, which can accurately reflect the activity of PMR.