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目的 :探讨类风湿性关节炎 (RA)患者血浆血小板膜颗粒蛋白 (GMP -14 0 )的变化及意义。方法 :用ELISA法检测 42例RA患者和 15例正常人血浆血小板GMP -14 0的含量 ,同时检测血小板计数 (BPC)及血沉 (ESR)。结果 :活动期RA(n=2 4)患者血浆血小板膜GMP -14 0含量 (5 8 32± 8 18μg/L)明显高于缓解期RA患者 (17 18± 2 5 8μg/L ,n=18)和正常对照组 (15 74± 2 33μg/L ,n =15 ) (P均 <0 0 0 1) ,而缓解期RA组与正常对照组之间无统计学差异 (P >0 0 5 )。活动期RA患者中有 15例进行了治疗前后的观察 ,经治疗RA病情得到控制后 ,GMP -14 0明显下降 ,接近正常。活动期RA患者血小板GMP -14 0含量与BPC呈正相关 (r=0 797,P<0 0 1) ;GMP -14 0及BPC与ESR也呈直线正相关 (r =0 45 9及 0 48;P均 <0 0 5 )。结论 :RA患者在病程中不仅有血小板数量的变化 ,同时有血小板的活化 ;其GMP -14 0含量及BPC的变化与疾病活动性有关 ,可能是一种继发性改变。临床上积极治疗原发病是阻止血小板活化 ,防止血栓形成的关键
Objective: To investigate the changes and clinical significance of plasma platelet membrane granule protein (GMP-140) in patients with rheumatoid arthritis (RA). Methods: The levels of plasma platelet GMP -14 in 42 RA patients and 15 healthy controls were detected by ELISA. The platelet count (BPC) and ESR were also measured. Results: The plasma GMP-140 level in patients with active RA (n = 24) was significantly higher than that in patients with remission (17 18 ± 25 58μg / L, n = 18 ) And normal control group (15 74 ± 2 33 μg / L, n = 15) (P all <0.01), while there was no significant difference between remission group and normal control group (P> 0.05) . Active RA patients in 15 cases were observed before and after treatment, after treatment of RA disease was controlled, GMP -14 0 decreased significantly, close to normal. The level of platelet GMP-140 in patients with active RA was positively correlated with BPC (r = 0 797, P 0 01). There was also a linear positive correlation between GMP -14 0 and BPC and ESR (r = 0 459 and 0 48; P <0 05). CONCLUSIONS: Not only the number of platelets but also the activation of platelets in RA patients during the course of their disease, the GMP-140 content and the change of BPC are related to disease activity, which may be a secondary change. The active treatment of primary disease in clinical is to prevent platelet activation, the key to prevent thrombosis