类风湿关节炎的血液学参数及其与疾病活动性的关系

Alshymaa Farouk, S. Abdel Rahman, Menna Allah Zakareya Abou Elwafa, F. Aboud
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摘要

背景:风湿病的炎症改变包括外周血细胞的形状、数量和大小的改变。全血细胞参数可用作炎症和疾病活动性的指标。工作目的:评估类风湿关节炎(RA)的血液学参数并确定其与疾病活动度的关系。方法:选取类风湿关节炎患者141例,健康对照100例。完成全部病史、全身和肌肉骨骼检查、DAS 28评分评估疾病活动性、炎症标志物、类风湿因子(RF)滴度、抗环瓜氨酸肽(anti-CCP)滴度和全血图像。结果:RA患者的红细胞、Hb、MPV、PWD和Hb/RDW%比均低于对照组,RDW%高于对照组。活动期RA患者有较高的白细胞、中性粒细胞和NLR。白细胞和中性粒细胞与DAS评分和CRP滴度呈正相关。NLR比值与DAS评分、CRP、Anti - CCP滴度呈正相关。活性RA具有较高的RDW%和较低的HCT、Hb、Hb/PLT、RDW%/PLT、Hb/RDW%比值。RDW%与DAS评分、ESR、CRP、RF、Anti - CCP滴度呈正相关。RDW%可区分活性RA和非活性RA,最佳临界值>12。活动期患者血小板和PLR较高,与DAS评分呈正相关。结论:血液学参数的变化与RA患者的疾病活动度显著相关,并与炎症标志物呈正相关。
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HEMATOLOGICAL PARAMETERS IN RHEUMATOID ARTHRITIS AND THEIR RELATIONSHIP WITH DISEASE ACTIVITY
: Background : Inflammatory changes in rheumatological diseases encompass alterations in shape, number, and size of peripheral blood cells. Complete blood cell parameters may be used as an index of inflammation and disease activity. Aim of the work: Assess the hematological parameters in rheumatoid arthritis (RA) and identify their relationship with disease activity. Methods : 141 patients with rheumatoid arthritis and 100 healthy controls were included in this study. Full medical history, general and musculoskeletal examination, assessment of disease activity using the DAS 28 score, markers of inflammation, rheumatoid factor (RF) titer, anti-cyclic citrullinated peptide (anti-CCP) titer and complete blood picture were done. Results : RA patients had lower RBCs, Hb, MPV, PWD and Hb/RDW% ratio and higher RDW% than controls. Active RA patients had higher WBCs, neutrophils, and NLR. WBCs and neutrophils were positively correlated with DAS score and CRP titre. NLR ratio correlated positively with the DAS score, CRP and Anti CCP titres. Active RA had higher RDW% and lower HCT, Hb, Hb/PLT, RDW%/PLT, Hb/RDW% ratios. RDW% was positively correlated with DAS score, ESR, CRP, RF and Anti CCP titres. The RDW% differentiated active and inactive RA with best cut-off value >12. Active patients had higher platelets and PLR, which were positively correlated with DAS score . Conclusion : Changes in haematological parameters are significantly associated with disease activity in RA patients and they correlate positively with inflammatory markers.
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