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目的探讨类风湿关节炎(RA)患者血红蛋白(Hb)水平与疾病活动度的相关性。方法收集2013年3月—2016年1月株洲市中心医院风湿免疫科就诊的资料完整的286例RA患者的Hb、血沉(ESR)、C反应蛋白(CRP)、类风湿关节炎患者病情评价(DAS28评分)及关节半定量彩色多普勒超声检查结果进行回顾性分析。根据患者Hb情况分为RA合并贫血组和RA不合并贫血组,并统计分析两组患者Hb浓度与疾病活动度评估指标(积液、增生滑膜、血流信号评分、骨侵蚀评分)的相关性。结果 286例患者中有53.85%(154例)出现贫血;RA合并贫血组ESR、CRP、DAS28评分、增生滑膜血流信号评分、骨侵蚀评分均高于RA不合并贫血组,差异有统计学意义(P<0.01);而两组关节积液总评分、增生滑膜总评分比较差异均无统计学意义(P>0.05)。Hb水平与ESR、DAS28评分、增生滑膜血流信号评分、骨侵蚀评分呈负相关(r值分别为-0.7、-0.62、-0.54、-0.53,P均<0.05)。结论 RA患者Hb水平与疾病活动度指标呈负相关,合并贫血的患者需要更积极的治疗。
Objective To investigate the correlation between hemoglobin (Hb) level and disease activity in patients with rheumatoid arthritis (RA). Methods A total of 286 RA patients with Hb, ESR, C-reactive protein (CRP) and rheumatoid arthritis were collected from March 2013 to January 2016 in rheumatology department of Zhuzhou Central Hospital DAS28 score) and joint semi-quantitative color Doppler ultrasound findings were retrospectively analyzed. According to the patients’ Hb, they were divided into RA-combined anemia group and RA-non-anemic group, and the correlation between Hb concentration and disease activity evaluation index (effusion, synovial hyperplasia, blood flow signal score and bone erosion score) Sex. Results Anemia was found in 53.85% (154 cases) of 286 patients. ESR, CRP, DAS28 score, synovial flow signal score and bone erosion score in RA combined anemia group were higher than those in RA non-anemia group (P <0.01). There was no significant difference between the two groups in total joint effusion score and synovial total score (P> 0.05). The level of Hb was negatively correlated with ESR, DAS28 score, hyperplastic synovial flow signal score and bone erosion score (r = -0.7, -0.62, -0.54, -0.53, P <0.05 respectively). Conclusions The level of Hb in patients with RA is negatively correlated with the index of disease activity, and the patients with anemia need more active treatment.