摘要
目的观察不同类风湿关节炎(rheumatoid arthritis,RA)中医证型的患者血浆D-二聚体(D-dimer,DD)水平的差异,并探讨其与血沉(erythrocyte sedimentation rate,ESR)、C反应蛋白(Creactive protein,CRP)等传统RA炎症指标的相关性。方法收集90例符合纳入标准的RA病例,采集一般资料、中医证型及DD、ESR、CRP等实验室指标,并对结果进行统计分析。结果所有入选病例中,DD水平升高者71例,占病例总数的82.2%。其中湿热夹瘀、瘀血痹阻、寒湿痹阻、湿热痹阻、阴虚夹瘀各组中DD水平均显著高于肾气虚寒及肝肾阴虚两组(P<0.01),其余各组间两两比较无统计学差异(P>0.05)。RA患者DD水平与ESR(r=0.573,P<0.01)、CRP(r=0.577,P<0.01)均呈显著正相关。结论 (1)RA患者体内DD高于正常水平,且湿热痹阻、瘀血痹阻、寒湿痹阻、湿热夹瘀、阴虚夹瘀型患者DD水平明显高于肾气虚寒、肝肾阴虚型患者,提示RA患者体内凝血/纤溶系统异常与中医学"湿、热、瘀"等实邪有关。(2)RA患者DD水平与ESR、CRP均呈显著正相关性,DD可能成为新的RA活动期检测指标。
Objective The study aims to observe the levels of serum D-Dimer（ DD） of patients with different traditional Chinese medicine（ TCM） syndromes of rheumatoid arthritis（ RA）,and explore correlations among DD,erythrocyte sedimentation rate（ ESR）,C-reactive protein（ CRP） and other traditional Inflammatory Markers of RA. Methods 90 RA cases meeting the criteria were collected,of which the epidemiological information,TCM syndromes,level of serum DD,ESR and CRP were analyzed by statistics. Results The level of DD increased in 71 cases,accounted for 82. 2% of the total. Among them,levels of DD in groups of damp-heat and blood stasis,static blood blocking collaterals,damp-cold stagnation,damp-heat stagnation and yin deficiency and blood stasis were significantly higher than groups of yang deficiency cold of kidney qi and liver-kidney-yin deficiency（ P〈0. 01）. The serum DD level of RA patients was significantly and positively correlated with both ESR（ r = 0. 573,P〈0. 01） and CRP（ r = 0. 577,P〈0. 01）. Conclusions（ 1） The level of serum DD in patients with RA were above normal level. Patients of damp-heat and blood stasis group,static blood blocking collaterals group,damp-cold stagnation group,damp-heat stagnation and yin deficiency and blood stasis group were shown a much higher level of DD than yang deficiency cold of kidney qi group and liver-kidney-yin deficiency group,which revealed that the abnormal changes of coagulation and fibrinolysis system of RA patients might be related to the pathogenic excess like damp,heat,blood stasis of TCM syndromes.（ 2） The serum DD level of RA patients was positively correlated to both ESR and CPR,which could be a new test index of RA.
出处
《环球中医药》
CAS
2015年第2期134-137,共4页
Global Traditional Chinese Medicine
基金
北京中医药大学自主选题(2013-JYB22-XS-138)
