CAJ | 학술논문

目的：探讨类风湿关节炎（RA）患者不同病情分期、中医证型的血栓前状态标志物的变化及意义。方法选择2012年1月-2014年3月新疆医科大学附属中医医院类风湿关节炎患者80例为研究对象，其中急性期RA患者40例（急性期 RA组），稳定期 RA患者40例（稳定期 RA组）；80例患者中中医辨证为湿热痹阻型22例、痰阻血瘀型18例、寒湿痹阻型28例、肝肾亏虚型12例，测定并分析4组中医证型患者血小板计数（PLT）、血小板平均体积（MPV）、血小板分布宽度（PDW）、血小板比积（PCT）、纤维蛋白酶原（FIB）、D-二聚体（D-D）、凝血酶原时间（PT）、中性粒细胞百分比（NEUT％）水平。结果急性期 RA组患者 PLT、MPV、FIB、D-D、PT、NEUT％水平均高于稳定期RA组患者，差异有统计学意义（P ＜0．01）；急性期RA组患者PDW和PCT水平与稳定期RA组比较差异无统计学意义（P ＞0．05）。各指标在中医证型中都以痰阻血瘀证中的变化最为明显。而4组中医证型患者的 MPV、PDW及PCT水平差异均无统计学意义（P ＞0．05）。结论急性期 RA患者较稳定期 RA患者的血栓前状态标志物变化更为明显，血栓前状态标志物可作为判定 RA患者病情分期的参考标准；RA患者中医证型与血栓前状态分子标志物检测指标水平差异明显，血栓前状态标志物水平可为 RA患者的中医临床辨证提供依据。
목적：탐토류풍습관절염（RA）환자불동병정분기、중의증형적혈전전상태표지물적변화급의의。방법선택2012년1월-2014년3월신강의과대학부속중의의원류풍습관절염환자80례위연구대상，기중급성기RA환자40례（급성기 RA조），은정기 RA환자40례（은정기 RA조）；80례환자중중의변증위습열비조형22례、담조혈어형18례、한습비조형28례、간신우허형12례，측정병분석4조중의증형환자혈소판계수（PLT）、혈소판평균체적（MPV）、혈소판분포관도（PDW）、혈소판비적（PCT）、섬유단백매원（FIB）、D-이취체（D-D）、응혈매원시간（PT）、중성립세포백분비（NEUT％）수평。결과급성기 RA조환자 PLT、MPV、FIB、D-D、PT、NEUT％수평균고우은정기RA조환자，차이유통계학의의（P ＜0．01）；급성기RA조환자PDW화PCT수평여은정기RA조비교차이무통계학의의（P ＞0．05）。각지표재중의증형중도이담조혈어증중적변화최위명현。이4조중의증형환자적 MPV、PDW급PCT수평차이균무통계학의의（P ＞0．05）。결론급성기 RA환자교은정기 RA환자적혈전전상태표지물변화경위명현，혈전전상태표지물가작위판정 RA환자병정분기적삼고표준；RA환자중의증형여혈전전상태분자표지물검측지표수평차이명현，혈전전상태표지물수평가위 RA환자적중의림상변증제공의거。
Objective To study the significance of markers of prethrombotic state in different clinical stages,TCM syndrome type in RA patients.Methods 80 RA patients in Affiliated Traditional Chinese Medical Hospital of Xinjiang Medical University from January 2012 to March 2014 were enrolled as the re-search obj ect,including 40 cases in acute stage(acute stage group)and 40 cases in stable stage(stable stage group);Among 80 patients,there were 22 cases of moist heat arthralgia spasm type,18 cases of phlegm accumulation and blood stasis type,28 cases of cold and damp blocking type and 12 cases of deficiency of the liver and kidney type based on the TCM differentiation.We tested the levels of PLT,MPV,PDW, PCT,FIB,D-D,PT and NEUT% in patients of 4 TCM syndrome groups.Results The levels of PLT, MPV,FIB,D-D,PT and NEUT% in acute stage were higher than those in stable stage,the differences were statistically significant (P <0.01);The comparison of the level of PDW and PCT in acute stage with that in stable stage showed no statistically significance (P>0.05).Each marker varies most significantly in phlegm accumulation and blood stasis type among the TCM syndrome.However,there was no statistical significance compared with the level of MPV,PDW and PCT in 4 TCM syndrome groups (P>0.05).Con-clusion The markers of prethrombotic state vary more significantly in acute RA patients than those in stable stage patients,the markers of prethrombotic state was considered as the relative standard of the clinical stages of RA patients;There were obvious differences of the level of the markers of prethrombotic state among different TCM syndrome groups in RA patients,the level of markers of prethrombotic state can provide evidence for TCM differentiation syndrome of RA patients.