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目的探讨D-二聚体在自身抗体阴性类风湿关节炎(RA)的诊断价值。方法回顾性分析自身抗体阴性RA患者(A组,26例)、自身抗体阳性RA患者(B组,190例)和非RA关节炎患者(C组,55例)的临床资料,探讨D-二聚体与RA活动性评估指标的相关性,并采用ROC曲线分析D-二聚体对RA患者的诊断价值。结果 A组血清D-二聚体水平高于C组(P<0.05)。D-二聚体与C反应蛋白、红细胞沉降率、RA活动性评分、Plt、红细胞分布宽度和类风湿因子呈正相关(P<0.05),与Hb和平均血小板体积呈负相关(P<0.05)。ROC曲线分析显示,D-二聚体诊断自身抗体阴性RA的AUC为0.70[95%CI(0.57~0.83)],灵敏度为0.92[95%CI(0.73~0.99)]。结论血清D-二聚体水平对自身抗体阴性的RA患者具有诊断意义,可用于疾病活动性评估。
Objective To investigate the diagnostic value of D-dimer in autoantibody-negative rheumatoid arthritis (RA). Methods The clinical data of autoantibodies negative RA patients (A group, 26 cases), autoantibody positive RA patients (B group, 190 cases) and non-RA arthritis patients (C group, 55 cases) were retrospectively analyzed. The correlation between D-dimer and RA activity was evaluated and the diagnostic value of D-dimer in patients with RA was analyzed by ROC curve. Results The level of serum D-dimer in group A was higher than that in group C (P <0.05). D-dimer was positively correlated with C-reactive protein, erythrocyte sedimentation rate, RA activity score, Plt, erythrocyte distribution width and rheumatoid factor (P <0.05), but negatively correlated with Hb and mean platelet volume . ROC curve analysis showed that the AUC of D-dimer for the diagnosis of autoantibody-negative RA was 0.70 [95% CI (0.57-0.83)] with a sensitivity of 0.92 [95% CI (0.73-0.99)]. Conclusions Serum D-dimer level is of diagnostic value for patients with autoantibodies negative RA, which can be used for disease activity assessment.