CD62p、IL-6和hs-CRP检测在类风湿性关节炎中的临床价值

CD62p,IL-6 and hs-CRP levels in rheumatoid arthritis

目的探讨类风湿性关节炎(RA)患者P选择素(CD62p)、白细胞介素6(IL-6)和高敏C反应蛋白(hs-CRP)水平的变化及意义。方法将50名体检健康者作为健康对照组,60例骨关节炎患者作为疾病对照组,将125例RA患者按疾病活动度分为高度活动期组(35例)、活动期组(42例)和缓解期组(48例)。分别检测各组受检者血小板CD62p阳性率及血清IL-6、hs-CRP水平。结果 RA组患者的血小板CD62p阳性率、血清IL-6和血清hs-CRP水平明显高于健康对照组(P<0.01);高度活动期组患者3个指标均明显高于活动期组和缓解期组(P<0.05),活动期组患者明显高于缓解期组(P<0.01)。选取活动期组和高度活动期组能随访到的患者52例,其中治疗有效者49例,在治疗后6个月时3个指标明显较治疗前下降(P<0.01),在治疗后12个月时CD62p阳性率和hs-CRP水平均较治疗后6个月时明显下降(P<0.01),且CD62p阳性率和hs-CRP水平与疾病活动指数28(DAS28)呈负相关(r值分别为0.325、0.547,P<0.05)。125例RA患者CD62p阳性率与IL-6和hs-CRP水平呈正相关(r值分别为0.450、0.539,P<0.01)。结论 RA患者血小板CD62p阳性率及血清IL-6、hs-CRP水平的高低与RA的病情变化相关,可为RA的诊疗提供依据。

Objective To investigate the changes and roles of cluster of differentiation 62 platelet（CD62p）,interleukin 6（IL-6） and high-sensitivity C-reactive protein（hs-CRP） levels in patients with rheumatoid arthritis（RA）. Methods A total of 50 healthy subjects were enrolled as healthy control group,and 60 patients with osteoarthritis were enrolled as disease control group. A total of 125 patients with RA were classified into 3 sub-groups,high active group（35 cases）,active group（42 cases） and remission group（48 cases）. The positive rate of CD62p and the levels of IL-6 and hs-CRP were determined. Results Compared with healthy control group,the positive rate of CD62p and the levels of IL-6 and hs-CRP were higher in RA group（P〈0.01）,those were higher in high active group than those in active group and remission group（P〈0.05）,and the positive rate and the levels were higher in active group than those in remission group（P〈0.01）. Totally,among 52 cases in high active and active groups who can be followed up,49 cases had effective treatment. The positive rate of CD62p and the levels of IL-6 and hs-CRP decreased after treatment for 6 months（P〈0.01）. After treatment for 12 months,the positive rate of CD62p and the level of hs-CRP decreased compared with those for 6 months（P〈0.01）. The positive rate of CD62p and the level of hs-CRP had negative correlations with disease activity score 28（DAS28）（r=0.325 and 0.547,P〈0.05）. The positive rate of CD62p and the levels of IL-6 and hs-CRP had positive correlations（r=0.450 and 0.539,P〈0.01）. Conclusions The positive rate of CD62p and the levels of IL-6 and hs-CRP in patients with RA re？ect the different states of disease,and they may provide a reference for the diagnosis and treatment of RA.