D-二聚体、纤维蛋白原、纤维蛋白(原)降解产物在强直性脊柱炎中的临床意义

Clinical significance of D-dimer, fibrinogen and fibrinogen degradation products in ankylosing spondylitis

目的探讨D-二聚体(DD)、纤维蛋白原(FIB)、纤维蛋白(原)降解产物(FDP)在强直性脊柱炎(AS)中的临床意义。方法选取2014年6月~2018年12月我院收治的60例AS患者及67例健康体检人群作为研究对象,比较其血浆DD、FIB及FDP水平,分析其与C反应蛋白(CRP)、红细胞沉降率(ESR)、血小板(PLT)及AS疾病活动指数评分(BASDAI)、AS功能指数评分(BASFI)的关系;同时将AS患者分为疾病活动组(BASDAI≥4分)和疾病缓解组(BASDAI<4分),比较分析两组患者的年龄、病程、DD、FIB、FDP、CRP、ESR、PLT、BASFI水平。结果①AS患者血浆DD、FIB、FDP水平高于健康对照者(P<0.05)。②AS疾病活动组患者的DD、FIB、FDP、ESR、BASFI高于疾病缓解组(P<0.05);AS疾病活动组患者的病程长于疾病缓解组(P<0.05);两组患者的年龄、CRP、PLT比较,差异无统计学意义(P>0.05)。③AS患者血浆DD、FIB、FDP水平与ESR、CRP、BASDAI、BASFI均成正相关(ρ=0.473、0.449、0.424、0.409,0.827、0.750、0.442、0.391,0.545、0.622、0.544、0.373;P<0.05)。④AS患者FDP与年龄成正相关(ρ=0.308,P<0.05),DD、FIB与年龄无相关性(P>0.05),DD、FIB、FDP与病程均无相关性(P>0.05)。结论AS患者,尤其在疾病活动期凝血-纤溶系统异常,与AS心血管损害、病程、疾病活动指标及功能指数相关,DD、FIB、FDP可作为评价AS疾病活动、功能的指标。

Objective To investigate the clinical significance of D-dimer(DD),fibrinogen(FIB)and fibrinogen degradation product(FDP)in ankylosing spondylitis(AS).Methods A total of 60 AS patients and 67 healthy people admitted to our hospital from June 2014 to December 2018 were selected as the subjects.The plasma levels of DD,FIB and FDP of them were compared and analyzed.The relationship between plasma levels of DD,FIB and FDP and C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),platelet(PLT),bath ankylosing spondylitis disease activity index(BASDAI)and bath ankylosing spondylitis functional index(BASFI)were analyzed.At the same time,AS patients were divided into disease active group(BASDAI≥4 points)and disease remission group(BASDAI<4 points).The levels of age and course of disease,DD,FIB,FDP,CRP,ESR,PLT,BASFI were compared and analyzed between the two groups.Results①The plasma levels of DD,FIB and FDP in AS patients were significantly higher than those in healthy controls(P<0.05).②The levels of DD,FIB,FDP,ESR and BASFI in AS disease active group were significantly higher than those in remission group(P<0.05).The course of disease in AS disease active group was longer than that in remission groupin AS disease active group were significantly higher than those in remission group(P<0.05).There was no significant difference in age,CRP and PLT between the two groups(P>0.05).③The levels of plasma DD,FIB and FDP in AS patients were positively correlated with ESR,CRP,BASFI and BASDAI(ρ=0.473,0.449,0.424,0.409,0.827,0.750,0.442,0.391,0.545,0.622,0.544,0.373;P<0.05).④FDP was positively correlated with age in AS patients(ρ=0.308,P<0.05).There was no correlation between DD,FIB and age in AS patients(P>0.05),and there was no correlation between DD,FIB,FDP and course of disease either(P>0.05).Conclusion In AS patients,especially in active stage,coagulation-fibrinolysis system is abnormal,which are related to the cardiovascular damage,course of AS,disease activity index and function index.DD,FIB and FDP may be used as indicators to evaluate the activity,function of AS.