本文選題：關(guān)節(jié)炎　切入點(diǎn)：類風(fēng)濕　出處：《寧夏醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探討血清學(xué)陰性類風(fēng)濕關(guān)節(jié)炎患者臨床表現(xiàn)、實(shí)驗(yàn)室檢驗(yàn)及影像學(xué)檢查特點(diǎn)。方法回顧2005年10月-2016年8月寧夏醫(yī)科大學(xué)總醫(yī)院確診為類風(fēng)濕關(guān)節(jié)炎(RA)的住院患者,等距收集249例。其中RF、ANA、ENA、AKA、CCP檢測(cè)均為陰性的RA患者30例(血清學(xué)陰性RA),同期上述5個(gè)指標(biāo)中至少一個(gè)為陽性的RA患者219例(血清學(xué)陽性RA)。分析兩組患者的臨床表現(xiàn)及實(shí)驗(yàn)室檢查結(jié)果的差異性。結(jié)果1、⑴血清學(xué)陰性RA女性晨僵率高于血清學(xué)陰性RA男性(68.42%比18.18%,P=0.008)及血清學(xué)陽性RA女性(68.42%比62.89%,P=0.036)。⑵血清學(xué)陰性RA男性晨僵率低于血清學(xué)陽性RA男性(18.18%比61.67%,P=0.020),晨僵時(shí)間短于血清學(xué)陰性RA女性(min:0比30,P=0.014),晨僵時(shí)間短于血清學(xué)陽性RA男性(min:0比20,P=0.011)。2、血清學(xué)陰性RA女性首發(fā)癥狀存在大關(guān)節(jié)痛的比例高于血清學(xué)陽性RA女性(78.95%比76.73%,P=0.014),出現(xiàn)功能障礙比例低于血清學(xué)陽性RA女性(26.31%比52.83%,P=0.039)。3、⑴血清學(xué)陰性RA患者血紅蛋白水平高于血清學(xué)陽性RA(g/L:129.00000比121.0000,P=0.002)。血清學(xué)陰性RA女性血紅蛋白水平低于血清學(xué)陰性RA男性(g/L:124.00比142.00,P=0.001)。血清學(xué)陰性RA女性血紅蛋白水平高于血清學(xué)陽性RA女性(g/L:124.00比116.00,P=0.003)。⑵血清學(xué)陰性RA血沉水平低于血清學(xué)陽性RA(mm/h:29.00比42.00,P=0.035),IgG水平低于血清學(xué)陽性RA(g/L:11.25比14.80,P=0.001),C4水平高于血清學(xué)陽性RA(g/L:0.25700比0.21700,P=0.009)。血清學(xué)陰性RA女性血沉水平低于血清學(xué)陽性RA女性(mm/h:33.00比44.00,P=0.028),CRP水平低于血清學(xué)陰性RA男性(mm/h:3.70000比39.80,P=0.012),CRP水平低于血清學(xué)陽性RA女性(mm/h:3.70000比18.70,P=0.018)。血清學(xué)陰性RA女性IgG水平低于血清學(xué)陽性RA女性(g/L:11.40比15.30,P=0.001),IgM水平高于血清學(xué)陰性RA男性(g/L:1.30比0.83,Z=-2.964,P=0.003)。血清學(xué)陰性RA男性IgM水平低于血清學(xué)陽性RA男性(g/L:0.83比1.30,P=0.018),C4水平高于血清學(xué)陽性RA男性(g/L:0.333比0.2515,P=0.024)。⑶血清學(xué)陰性RA出現(xiàn)關(guān)節(jié)III期改變比例高于血清學(xué)陽性RA(33.33%比12.32%,P=0.006)。血清學(xué)陰性RA男性關(guān)節(jié)III期改變的比例高于血清學(xué)陽性RA男性(54.55%比5.00%,P=0.001)。⑷血紅蛋白與血沉、IgG及C4水平呈負(fù)相關(guān),IgG與血沉呈正相關(guān),與C4水平呈負(fù)相關(guān)。結(jié)論1、血清學(xué)陰性RA患者貧血程度輕,炎癥程度較低,更易出現(xiàn)骨侵蝕。2、血清學(xué)陰性RA男性患者IgG水平低、C4水平高。3、血清學(xué)陰性RA女性患者晨僵持續(xù)時(shí)間長、首發(fā)癥狀中大關(guān)節(jié)痛發(fā)生率高,關(guān)節(jié)功能障礙發(fā)生少。
[Abstract]:Objective to investigate the clinical manifestations, laboratory tests and imaging features of patients with sero-negative rheumatoid arthritis (RA). Methods the hospitalized patients with rheumatoid arthritis (RA) diagnosed in the General Hospital of Ningxia Medical University from October 2005 to August 2016 were retrospectively reviewed. A total of 249 patients were collected at isometric intervals. 30 patients (seronegative rags) were found in 30 RA patients (seronegative rags), and at least one of the above five markers was positive in 219 patients (serologically positive rags). The clinical manifestations and clinical manifestations of the two groups were analyzed. Results 1the morning stiffness rate of sero-negative RA women was higher than that of sero-negative RA males (68.42% vs 18.18g P0.008) and seropositive RA women (68.42% vs 62.89g / 0.036.2%). The duration of morning stiffness was shorter than that of sero-negative RA women, and the morning stiffness time was shorter than that of seropositive RA women. The morning stiffness time was shorter than that of seropositive RA males. The incidence of significant arthralgia in sero-negative RA women was higher than that in seropositive RA women. The hemoglobin level of seropositive RA women was lower than that of seropositive RA women (26.31% vs 52.83% vs 52.83%). The hemoglobin level of seropositive RA women was higher than that of seropositive RA(g/L:129.00000 patients than that of seropositive RA women. The hemoglobin level of sero-negative RA women was lower than that of sero-negative RA women. The hemoglobin level of sero-negative RA women was higher than that of seropositive RA women (124.00: 116.00 P0. 003.2). The ESR level of seropositive RA was lower than that of serologically positive RA(mm/h:29.00 (42.00P0.03535). The level of ESR in sero-negative RA women was lower than that in seropositive RA women (3.70000 vs 18.70000 vs 18.70P0.018). The IgG level in sero-negative RA women was lower than that in sero-negative RA women. The level of IgM in seropositive RA women was lower than that in seropositive RA women (g / L = 15.30: 15.30 / 15.30: 0.001). The level of IgM in seropositive RA women was lower than that in seropositive RA women (g / L = 15.30 / 15.30). The level of IgM in seropositive RA women was higher than that in seropositive RA men (g / L = 0.2515P0.024.3 / 0.2515P0.024.3), and the level of IgM in seropositive RA women was higher than that in seropositive RA men (g / L = 0.2515P 0.024.3). The incidence of joint III phase changes in seropositive RA patients was higher than that in seropositive RA patients (33.33% vs 12.32% vs 12.32%). The incidence of joint III phase changes in sero-negative RA men was higher than that in seropositive RA men (54.55% vs 5.00%). There was a positive correlation between IgG and ESR. Conclusion 1.The anemia degree and inflammation degree of sero-negative RA patients are lower than those of sero-negative RA patients. Bone erosion was more likely to occur in sero-negative RA male patients with lower IgG level and higher C4 level. The duration of morning stiffness in sero-negative RA women was longer. The incidence of major arthralgia and joint dysfunction were high in the initial symptoms.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R593.22

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 曲世晶;葉華;賈汝琳;栗占國;;血清學(xué)陰性類風(fēng)濕關(guān)節(jié)炎關(guān)節(jié)液中抗環(huán)瓜氨酸肽抗體、抗突變型瓜氨酸波形蛋白抗體的測(cè)定及臨床意義[J];北京大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2016年06期

2 李寶貞;莫漢有;石宇紅;許佳;;修訂分類標(biāo)準(zhǔn)診斷血清學(xué)陰性與陽性類風(fēng)濕關(guān)節(jié)炎臨床特征的比較[J];東南大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2016年05期

3 慈維蘋;潘麗麗;廖華;萬瑾;王天;;不同性別類風(fēng)濕關(guān)節(jié)炎患者臨床特點(diǎn)對(duì)比分析[J];新鄉(xiāng)醫(yī)學(xué)院學(xué)報(bào);2016年05期

4 張國棟;林輝;劉毅;;血清學(xué)陰性類風(fēng)濕關(guān)節(jié)炎診治進(jìn)展[J];西部醫(yī)學(xué);2015年11期

5 王麗;;血清學(xué)陰性與血清學(xué)陽性類風(fēng)濕關(guān)節(jié)炎患者的臨床特點(diǎn)[J];臨床合理用藥雜志;2015年29期

6 潘亞男;;紅細(xì)胞沉降率測(cè)定的方法及臨床意義[J];中國衛(wèi)生標(biāo)準(zhǔn)管理;2014年21期

7 王亞黎;劉健;葉文芳;阮麗萍;萬磊;;類風(fēng)濕關(guān)節(jié)炎患者免疫球蛋白變化及相關(guān)因素分析[J];中國臨床保健雜志;2014年02期

8 劉童;李興銳;徐勝前;;抗環(huán)瓜氨酸肽抗體和類風(fēng)濕因子雙陽性類風(fēng)濕關(guān)節(jié)炎患者臨床資料分析[J];中華臨床醫(yī)師雜志(電子版);2013年22期

9 曾玉琴;胡清;李雪鋒;朱建勇;;血清抗角蛋白抗體譜測(cè)定對(duì)類風(fēng)濕關(guān)節(jié)炎骨侵蝕的預(yù)測(cè)價(jià)值[J];現(xiàn)代生物醫(yī)學(xué)進(jìn)展;2013年02期

10 張玉萍;;抗CCP、AKA及RF聯(lián)合診斷類風(fēng)濕關(guān)節(jié)炎的臨床研究[J];中國社區(qū)醫(yī)師(醫(yī)學(xué)專業(yè));2012年22期

，

本文編號(hào)：1627754