类风湿关节炎合并感染患者血小板活化、血小板参数及炎症介质的变化研究

Changes of platelet activation,platelet parameters,and inflammatory mediators of rheumatoid arthritis patients complicated with infections

目的研究及分析类风湿关节炎合并感染患者血小板活化、血小板参数及炎症介质的变化,为该病的治疗与诊断提供参考依据。方法选取2014年2月-2016年3月医院收治35例类风湿关节炎合并感染患者为A组,35例仅类风湿关节炎患者为B组,35名健康体检者为C组,然后将3组血小板活化、血小板参数及炎症介质相关血清指标进行分别检测与比较,并比较A组中细菌感染与真菌感染患者的上述指标。结果 A组血小板活化指标CD62p、CD63、GPⅡb/Ⅲa及GMP-140分别为(5.51±0.42)%、(3.31±0.32)%、(27.81±2.45)%及(14.51±1.46)%,均高于B组(3.45±0.23)%、(3.31±0.32)%、(27.81±2.45)%、(14.51±1.46)%及C组(1.65±0.15)%、(1.82±0.20)%、(16.22±1.70)%、(8.23±0.77)%,A组血小板参数及炎症介质相关血清指标均差于B组及C组,B组则差于C组,A组中真菌感染患者检测结果则差于细菌感染患者,差异均有统计学意义(P<0.05)。结论类风湿关节炎合并感染患者血小板活化、血小板参数及炎症介质表达相对异常,且其检测对于感染情况的鉴别也有积极的临床意义。

OBJECTIVE To investigate the changes of platelet activation ,platelet parameters ,and inflammatory me‐diators of rheumatoid arthritis patients complicated with infection so as to provide guidance for diagnosis and treat‐ment of the disease .METHODS Totally 35 rheumatoid arthritis patients complicated with infection who were trea‐ted in the hospital from Feb 2014 to Mar 2016 were assigned as the group A ,35 patients with single rheumatoid arthritis were assigned as the group B ,and 35 healthy people who received physical examination were set as the group C .The platelet activation ,platelet parameters ,and inflammatory mediators‐related serological indexes were detected and compared among the three groups ;the above indexes were compared between the patients with bacte‐rial infection and the patients with fungal infection in the group A .RESULTS As compared with the platelet activa‐tion indexes ,the CD62p of the group A was （5 .51 ± 0 .42）% ,higher than （3 .45 ± 0 .23）% of the group B and （1 .65 ± 0 .15）% of the group C ;the CD63 of the group A was （3 .31 ± 0 .32）% ,higher than （3 .31 ± 0 .32）% of the group B and （1 .82 ± 0 .20）% of the group C ;the GPⅡb/Ⅲa of the group A was （27 .81 ± 2 .45）% ,higher than （27 .81 ± 2 .45）% of the group B and （16 .22 ± 1 .70）% of the group C ;the CMP‐40 of the group A was （14 . 51 ± 1 .46）% ,higher than （14 .51 ± 1 .46）% of the group B and （8 .23 ± 0 .77）% of the group C .The platelet pa‐rameters and inflammatory mediators‐related serological indexes of the group A were worse than those of the group B and the group C ,which were worse in the group B than in the group C .In the group A ,the detection results of the patients with fungal infection were worse than those of the patients with bacterial infection ,and there was sig‐nificant difference （P〈0 .05） .CONCLUSION The rheumatoid arthritis patients complicated with infection show relatively abnormal platelet activation , platelet parameters , and expression of inflammatory mediators ;the detection of the above indexes has positive clinical significance in identification of the infection .