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目的探讨痛风性关节炎和类风湿关节炎患者关节液和血液相关指标的变化,分析其临床意义。方法检测2014年1月-12月收治的75例痛风性关节炎患者和68例类风湿关节炎患者关节液常规指标,包括白细胞计数(WBC)、总蛋白(TP)、白蛋白(ALB)、葡萄糖(GLU)、尿酸(UA),血液指标包括免疫球蛋(Ig)G、Ig M、Ig A、补体C3、C4、类风湿因子(RF)、抗链球菌溶血素O(ASO)、C反应蛋白(CRP)。结果关节液指标中,TP、ALB水平在两组关节炎中无明显差异(P>0.05),WBC、GLU、UA、RF、ASO水平在两组关节炎中有明显差异(P<0.05);血液指标中,C4两组间无明显差异(P>0.05),两组间的Ig G、Ig M、Ig A、CRP、C3、UA、RF、ASO差异有统计学意义(P<0.05)。且ASO在两组疾病中关节液的检出水平均高于血液检出水平(P<0.05)。在两组疾病中UA在关节液中和血液中,差异均无统计学意义(P>0.05)。在痛风性关节炎中RF水平在关节液和血液中差异有统计学意义(P<0.05);类风湿关节炎中RF的血液检出水平和关节液检出水平,差异无统计学意义(P>0.05)。ASO在痛风性关节液的血液和关节液的阳性分别是38.7%和44.0%,在类风湿关节炎的血液中75.0%阳性,关节液中73.5%阳性;痛风性关节炎92.0%血液UA为阳性,80.0%关节液阳性,而类风湿性关节炎血液中UA阳性率为38.2%,关节液里32.4%阳性;血液中的RF在痛风性关节炎中血液仅33.3%,而关节液阳性率为40.0%,在类风湿关节炎中的阳性率是86.8%,关节液中的阳性率91.2%。结论两组疾病患者的关节液和血液指标都在发生改变,在疾病的诊断和疗效的观察中有一定的临床价值。
Objective To investigate the changes of synovial fluid and blood-related indices in patients with gouty arthritis and rheumatoid arthritis and analyze its clinical significance. Methods The common indexes of synovial fluid including 75 cases of gouty arthritis and 68 cases of rheumatoid arthritis were detected from January 2014 to December 2014, including WBC, total protein (TP), albumin (ALB) GLU, UA, blood indicators including Ig G, Ig M, Ig A, complement C3, C4, rheumatoid factor (RF), anti streptolysin O (ASO), C Reactive protein (CRP). Results The levels of TP and ALB in the synovial fluid showed no significant difference between the two groups (P> 0.05). The levels of WBC, GLU, UA, RF and ASO were significantly different between the two groups (P <0.05). There was no significant difference between the two groups in blood index (P> 0.05). The differences of Ig G, Ig M, Ig A, CRP, C3, UA, RF and ASO between the two groups were statistically significant (P <0.05). And ASO in both groups disease detected levels of synovial fluid were higher than the level of blood (P <0.05). UA in the two groups of diseases in the joint fluid and blood, the difference was not statistically significant (P> 0.05). The level of RF in gouty arthritis was significantly different in synovial fluid and blood (P <0.05). There was no significant difference in RF level between blood and synovial fluid in rheumatoid arthritis (P > 0.05). The positive rates of blood and synovial fluid of ASO in gouty joint fluid were 38.7% and 44.0% respectively, 75.0% were positive in rheumatoid arthritis blood and 73.5% in synovial fluid. Gouty arthritis was positive in 92.0% of blood UA , While 80.0% were positive for synovial fluid. However, the positive rate of UA in blood was 38.2% in rheumatoid arthritis and 32.4% in synovial fluid. The blood RF was only 33.3% in gouty arthritis, while the positive rate of synovial fluid was 40.0%. The positive rate was 86.8% in rheumatoid arthritis and 91.2% in synovial fluid. Conclusion The synovial fluid and blood indexes of patients in both groups are changing, and it has certain clinical value in the diagnosis of disease and the observation of curative effect.