Dr DY Patil Hospital, Pimpri, Pune.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
Rheumatoid Arthritis is a chronic inflammatory disease of unknown etiology characterised by presence of symmetric involvement of multiple joints, mainly small joints that rapidly progresses to multisystem inflammation. Common haematological abnormalities observed are anemia,leucocytosis, neutropenia, thrombocytosis, thrombocytopenia, eosinophilia and haematological malignancies. This study is aimed at the various haematological parameters observed in newly diagnosed patients of rheumatoid arthritis and correlating it with disease activity measured by indices like DAS 28 CRP and HAQDI.
Patients more than 16 years of age and newly diagnosed cases of rheumatoid arthritis according to the ACR EULAR 2010 criteria who presented in the rheumatology opd were included in the study. A total of 20 patients fulfilling the inclusion criteria were studied.Any patient with active blood loss from any site, infection,chronic liver or kidney disease, malignancies,hematological diseases,those already on disease modifying drugs,other autoimuune diseases were excluded from the study.
Out of 20 patients of rheumatoid arthritis studied,55%(11) had anemia of chronic disease and 27.5%(5) had iron deficiency anemia,3%(1) had eosinophilia. The disease activity was measured using DAS 28 CRP and HAQ DI. A negative correlation was observed between Hb level and disease activity whereas a positive correlation was observed between platelet count and disease activity.
In our study it was observed that Hb is significantly lower in patients with high disease activity whereas platelet count and MPV are significantly higher with high disease activity compared to patients with low to moderate disease activity.So, from Hb level, platelet count and MPV, we can predict disease activity in RA patients which can guide us for proper and aggressive management to prevent further disease progression.
观察新诊断的类风湿关节炎患者的各种血液学参数，并将其与 DAS28-CRP 和 HAQDI 等指标测量的疾病活动度相关联。
纳入了在风湿科门诊就诊的年龄超过 16 岁且符合 ACR/EULAR 2010 标准的新诊断类风湿关节炎患者。共研究了 20 名符合纳入标准的患者。患有任何部位活动性失血、感染、慢性肝或肾病、恶性肿瘤、血液疾病、已接受疾病修正药物治疗、其他自身免疫性疾病的患者被排除在研究之外。
在研究的 20 例类风湿关节炎患者中，55%（11 例）患有慢性疾病性贫血，27.5%（5 例）患有缺铁性贫血，3%（1 例）患有嗜酸性粒细胞增多症。使用 DAS28-CRP 和 HAQDI 测量疾病活动度。观察到 Hb 水平与疾病活动度呈负相关，而血小板计数和 MPV 与疾病活动度呈正相关。
在我们的研究中观察到，Hb 在疾病活动度高的患者中显著降低，而血小板计数和 MPV 在疾病活动度高的患者中显著高于疾病活动度低至中度的患者。因此，我们可以通过 Hb 水平、血小板计数和 MPV 来预测 RA 患者的疾病活动度，从而指导我们进行适当和积极的管理，以防止疾病进一步进展。
