类风湿性关节炎患者血小板参数变化对疾病活动度的诊断价值

Diagnostic Value of Platelet Parameters Changes on Disease Activity in Patients with Rheumatoid Arthritis

目的探讨类风湿性关节炎(RA)患者血小板参数变化对其疾病活动度的诊断价值.方法回顾性分析120例RA患者临床资料,并纳入65例同期健康体检者作为健康对照组.根据120例RA疾病活动度分为疾病活动组(RA活动期组)、临床缓解组(RA缓解期组),比较两组血小板计数(PLT)、血小板压积(PCT)、血小板分布宽度(PDW)、血小板平均体积(MPV)水平差异,并使用受试者工作特征曲线(ROC曲线)评估上述血小板参数对RA疾病活动度的诊断效能.结果120例RA患者中28个关节疾病活动度评分(disease activity score,DAS28)≥2.6分77例,纳入RA活动期组;DAS28评分<2.6分43例,纳入RA缓解期组.RA缓解期组PLT、PCT水平明显高于健康对照组(P<0.05),且RA活动期组PLT、PCT水平高于RA缓解期组及健康对照组(P<0.05);RA缓解期组PDW、MPV水平明显低于健康对照组(P<0.05),且RA活动期组PDW、MPV水平低于RA缓解期组及健康对照组(P<0.05).结论PLT、PCT、PDW、MPV对RA疾病活动度诊断价值较高,临床可考虑将上述血小板参数纳入诊疗新指标用于RA的诊断与治疗.

Objective To explore the diagnostic value of platelet parameters changes on disease activity in patients with rheumatoid arthritis(RA).Method The clinical data of 120 RA patients were retrospectively analyzed,and 65 healthy subjects with physical examination at the same period were included as healthy control group.According to RA disease activity in 120 cases of RA,they were divided into disease activity group(RA active group)and clinical remission group(RA remission group).The platelet count(PLT),thrombocytocrit(PCT),platelet distribution width(PDW)and mean platelet volume(MPV)were compared between the two groups.The receiver operating characteristic curve(ROC curve)was used to evaluate the diagnostic efficacy of the above platelet parameters on RA disease activity.Results Among 120 patients with RA,77 cases with DAS score(disease activity score,DAS 28)≥2.6 points were included in RA active group,and 43 cases with DAS28 score<2.6 points were included in RA remission group.The levels of PLT and PCT in RA remission group were higher than those in healthy control group(P<0.05),and the levels of PLT and PCT in RA active group were higher than those in RA remission group and healthy control group(P<0.05).The levels of PDW and MPV in RA remission group were lower than those in healthy control group(P<0.05),and the levels of PDW and MPV in RA active group were lower than those in RA remission group and healthy control group(P<0.05).Conclusion PLT,PCT,PDW and MPV have high diagnostic value on RA disease activity.The above platelet parameters can be considered as new indicators for diagnosis and treatment in clinical practice,and they are beneficial to the diagnosis and treatment of RA.