中文摘要：

目的探讨类风湿关节炎（RA）患者血小板与免疫功能、炎症指标的相关性及其临床意义。方法收集2010年6月—2012年6月收治的90例RA患者,其中62例为活动期RA（活动期RA组）,28例为缓解期RA（缓解期RA组）,对照组为同期就诊资料完整的膝骨关节炎21例（OA组）。采用魏氏法测定红细胞沉降率（ESR）,全自动血细胞分析仪测定血小板参数,全自动生化分析仪测定C反应蛋白（CRP）及IgA、IgG、IgM,流式细胞技术测定T淋巴细胞亚群。结果与缓解期RA组和OA组比较,活动期RA组血小板计数（PLT）、血小板压积（PCT）显著增高（P〈0.01）,血小板分布宽度（PDW）、血小板平均体积（MPV）、大型血小板比率（P-LCR）显著降低（P〈0.01）;缓解期RA组PCT明显高于OA组（P〈0.05）;活动期RA组ESR、CRP、IgA、IgG显著高于缓解期RA组和OA组（P〈0.01）,Ig M显著高于OA组（P〈0.01）;缓解期RA组Ig A显著高于OA组（P〈0.01）;与缓解期RA组比较,活动期RA组CD8＋T淋巴细胞百分比明显降低（P〈0.05）,CD4＋/CD8＋比值明显增高（P〈0.05）;与OA组比较,活动期RA组CD4＋T淋巴细胞百分比显著增高（P〈0.01）,CD8＋T淋巴细胞百分比明显降低（P〈0.05）,CD4＋/CD8＋比值显著增高（P〈0.01）;缓解期RA组CD4＋T淋巴细胞百分比明显高于OA组（P〈0.05）。PLT与PCT、ESR、CRP、IgG、IgM呈显著正相关（P〈0.01,P〈0.05）,而与P-LCR、PDW、MPV呈显著负相关（P〈0.01）,与T淋巴细胞亚群各指标无明显相关（P〉0.05）。结论血小板计数与RA炎症及体液免疫指标具有明显相关性,血小板及其相关因子可能成为RA治疗的新靶点。

英文摘要：

Objective To explore the correlation between platelet counts with indexes of immune function and inflammation in patients with rheumatoid arthritis and its clinical significance. Methods A total of 90 patients with rheumatoid arthritis admitted during June 2010 and June 2010 were recruited in this study,including 62 patients with active RA（ active RA group） and 28 patients with inactive RA（ inactive RA group）. The other 21 knee osteoarthritis（ OA）patients（ OA group） with complete data were chosen as the control group. The erythrocyte sedimentation rate（ ESR） was detected using Westergren method; platelet parameters were detected using automatic blood cell cytoanalyzer; levels of CRP（ C-reactive protein）,Ig A（ immunoglobulin A）,Ig G and Ig M were detected using automatic biochemistry analyzer;T lymphocyte subgroups were detected using flow cytometry. Results Compared with those in inactive RA and OA groups,values of platelet count（ PLT） and platelet hematocrit（ PCT） in active RA group were significantly increased（ P〈0. 01）,values of platelet distribution width（ PDW）,mean platelet volume（ MPV） and platelet-large cell rate（ PLCR） were significantly decreased（ P〈0. 01）; the PCT value in inactive RA group was significantly higher than that in OA group（ P〈0. 05）. The levels of ESR,CRP,Ig A and Ig G in active RA group were significantly increased than those in inactive RA and OA groups（ P〈0. 01）,and the Ig M level in active RA group was higher than that in OA group（ P〈0. 01）. The Ig A level in inactive RA group was significantly higher than that in OA group（ P〈0. 01）. Compared with those in inactive RA group,the percentage of CD8 ＋ T lymphocyte in active RA group was significantly decreased（ P〈0. 05）,the ratio of CD4 ＋ /CD8 ＋ was significantly elevated（ P〈0. 05）. Compared with those in OA group,the percentage of CD4 ＋ T lymphocyte in active RA group was significantly increased（ P〈0. 01）,the percentage of CD8 ＋