Ertenli I, Kiraz S, Arici M, Haznedaroglu I C, Calgüneri M, Celik I, Kirazli S
Department of Internal Medicine, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
J Rheumatol. 1998 Jun;25(6):1054-8.
To compare plasma concentrations of soluble P-selectin (sP-selectin) in patients with rheumatoid arthritis (RA) and thrombocytosis with those with RA with normal platelet counts and healthy controls, and to explore the relationship between clinical and serological measures of disease activity.
Nineteen patients with RA with marked thrombocytosis, 20 with normal platelet counts, and 24 controls were enrolled. Ritchie articular index and morning stiffness were recorded as clinical markers of disease activity. Blood samples were collected for platelet count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and plasma sP-selectin determinations. Correlations between sP-selectin and clinical and serological markers of disease activity were noted.
Patients with RA and thrombocytosis compared to patients with normal platelet counts showed evidence of more active disease when ESR, CRP, morning stiffness, and Ritchie articular index were considered. The thrombocyte count in patients with RA with marked thrombocytosis revealed a positive correlation with CRP and Ritchie articular score. Plasma sP-selectin levels were found to be significantly higher in patients with RA compared to controls. sP-selectin levels were significantly higher in patients with RA with thrombocytosis compared to those with normal platelet counts, and positive correlations were observed between plasma sP-selectin levels and Ritchie index, morning stiffness, and thrombocyte counts in those patients.
Elevated plasma sP-selectin levels in RA could indicate the presence of a continuous underlying inflammatory stimulus. In addition, the augmented increase in patients with RA and thrombocytosis and its correlation with clinical activity may imply the cytokine-adhesion molecule interaction mediates the chronic inflammation of RA.
比较类风湿关节炎（RA）伴血小板增多症患者与血小板计数正常的RA患者及健康对照者血浆可溶性P选择素（sP选择素）浓度，并探讨疾病活动的临床和血清学指标之间的关系。
纳入19例RA伴明显血小板增多症患者、20例血小板计数正常的RA患者和24例对照者。记录Ritchie关节指数和晨僵作为疾病活动的临床指标。采集血样测定血小板计数、红细胞沉降率（ESR）、C反应蛋白（CRP）和血浆sP选择素。记录sP选择素与疾病活动的临床和血清学指标之间的相关性。
当考虑ESR、CRP、晨僵和Ritchie关节指数时，与血小板计数正常的RA患者相比，RA伴血小板增多症患者显示出疾病更活跃的证据。RA伴明显血小板增多症患者的血小板计数与CRP和Ritchie关节评分呈正相关。发现RA患者的血浆sP选择素水平显著高于对照者。与血小板计数正常的RA患者相比，RA伴血小板增多症患者的sP选择素水平显著更高，并且在这些患者中观察到血浆sP选择素水平与Ritchie指数、晨僵和血小板计数之间呈正相关。
RA患者血浆sP选择素水平升高可能表明存在持续的潜在炎症刺激。此外，RA伴血小板增多症患者中sP选择素水平的进一步升高及其与临床活动的相关性可能意味着细胞因子-黏附分子相互作用介导了RA的慢性炎症。
