Analysis Of Clinical Characteristics Of Patients With Rheumatoid Arthritis Complicated With Thrombocytosis

Objective:To study the clinical characteristics of patients with rheumatoid arthritis(RA)complicated with thrombocytosis,to evaluate the related factors of thrombocytosis,and to explore the value of blood routine indexes in the evaluation of disease activity.Method:The medical records of RA patients admitted in our hospital from January 2017to July 2018 were analyzed retrospectively.The patients were divided into two groups according to whether their platelet count was>300×10~9/L,namely,high platelet count group and normal platelet group.The differences in general conditions,smoking history,complications,complications,laboratory examinations and disease evaluation between the two groups were compared.The relationship between platelets and other indicators was studied by regression analysis,and the correlation between blood routine indicators and disease activity indicators was analyzed.Result:1.A total of 202 patients with RA were enrolled in the study,including 76 in the high platelet count group and 126 in the normal platelet group.2.There were no significant differences in Sex ratio,age of onset,course of disease,duration of morning stiffness,number of joint swelling,number of joint tenderness,smoking history,comorbidities(diabetes,hypertension,hyperuricemia,hyperlipidemia),complications,RBC,ALT,AST,TP,TBIL,DBIL,Cr,Urea,UA,Ca,25-hydroxyvitamin D3,TC,TG,LDL-C,IgA,IgM,C4,RF,and anti-CCP antibody levels(P>0.05).Meanwhile,WBC,N,CRP,ESR,IgG,C3,VAS score,PGA,PhGA,DAS28 score,SDAI and CDAI were compared,The high platelet count group was higher than the normal platelet group(P<0.05);while compared with Hb,ALB and HDL-C,The high platelet count group was lower than the normal platelet group(P<0.05).3.Non-conditional Logistic regression analysis showed that high activity and high IgG level were the risk factors for RA with thrombocytosis.4.Platelet count was positively correlated with ESR,CRP and DAS28CRP scores(r=0.252,0.322,0.398,P<0.05),but not significantly correlated with joint swelling and joint tenderness.Platelet volume was positively correlated with ESR,CRP and DAS28CRP scores(r=0.267,0.202,0.393,P<0.05),but not significantly correlated with joint swelling and joint tenderness.WBC count was positively correlated with ESR,CRP and DAS28CRP scores(r=0.179,0.188,0.159,P<0.05),but not significantly correlated with joint swelling and joint tenderness.Neutrophil count was positively correlated with ESR,CRP and DAS28CRP scores(r=0.213,0.241,0.152,P<0.05),but not significantly correlated with joint swelling and joint tenderness.Red blood cell count was negatively correlated with CRP(r=-0.286,P<0.05),but was not significantly correlated with ESR,number of joint swelling,number of joint tenderness,and DAS28CRP score.Hemoglobin was negatively correlated with ESR and CRP(r=-0.288,-0.376,P<0.05),but not significantly correlated with number of joint swelling,number of joint tenderness,and DAS28CRP score.Platelet distribution width,mean platelet volume and large platelet ratio were not significantly correlated with ESR,CRP,number of joint swelling,number of joint tenderness,and DAS28CRP score.Conclusion:RA patients with thrombocytosis tend to have higher disease activity levels,accompanied by increased inflammatory indicators and abnormal immune indicators,early lipid metabolism disorders,and are also prone to be associated with anemia and hypoalbuminemia.Moreover,leukocyte count,neutrophil count and platelet volume are positively correlated with disease activity.Platelet,white blood cell,neutrophil counts and platelet volume may be able to predict the activity of RA.high activity and high IgG level were the risk factors for RA with thrombocytosis.