来源：风湿病与关节炎,2020,9（11）:10-13.

痛风性关节炎患者凝血指标变化及相关性分析（临床研究）

韩馨悦¹，刘　健²，张　颖¹，忻　凌²，贺明玉¹，高金栋¹

　　【摘　要】目的：研究痛风性关节炎患者凝血指标的变化，分析其与尿酸及免疫、炎症指标的关系。方法：选取安徽中医药大学第一附属医院风湿科324例痛风性关节炎住院患者的病历资料，采用SPSS 23.0统计软件，以实验室指标相关性分析等方法进行数据挖掘。采用SPSS Clementine 17.0软件Aprior模块分析痛风性关节炎患者凝血指标纤维蛋白原（FBG）、D-二聚体（DD）、凝血酶原时间（PT）、部分凝血酶原时间（APTT）与免疫指标免疫球蛋白A（IgA）、免疫球蛋白M（IgM）、免疫球蛋白G（IgG）、补体C3（C3）、补体C4（C4），炎症指标C-反应蛋白（CRP）、红细胞沉降率（ESR）及尿酸（UA）的关联程度。结果：①凝血指标值分析显示，324例GA患者FBG上升162例（50.00%），DD上升136例（41.98%）。②相关性分析显示，FBG与IgA、C3、C4、CRP、ESR呈正相关（P < 0.05），DD与CRP、ESR呈正相关（P < 0.05），PT与IgG、CRP呈正相关（P < 0.05）。③Logistic回归分析显示，C3、C4、CRP、ESR是FBG升高的危险因素，IgG、CRP、ESR是DD升高的危险因素，IgM是APTT降低的危险因素。④关联结果分析显示，设定最小置信度为80%，最小支持度为20%，提取与FBG上升关联较高的指标分别是CRP、ESR、C3、C4，与DD上升关联较高的指标分别是CRP、ESR、C3、C4、UA，其提升度均 > 1。结论：痛风性关节炎患者存在高凝状态，主要表现在FBG和DD的上升。凝血指标与免疫、炎症及尿酸具有相关性，免疫、炎症指标是凝血指标异常的危险因素，其变化可能参与痛风性关节炎的发生及发展过程。

　　【关键词】　痛风性关节炎；凝血指标；尿酸；高凝状态；数据挖掘

Changes and Correlation Analysis of Coagulation Indexes in Patients with Gouty Arthritis

HAN Xin-yue,LIU Jian,ZHANG Ying,XIN Ling,HE Ming-yu,GAO Jin-dong

　　【ABSTRACT】Objective:To study the changes of coagulation indexes in patients with gouty arthritis,and analyze its relationship with uric acid,immune and inflammatory indexes.Methods:The data of 324 gouty arthritis inpatients in Rheumatology Department of the First Affiliated Hospital of Anhui University of Chinese medicine were selected by data mining method.Statistical software SPSS 23.0 and correlation analysis of laboratory indexes were used for data mining.APRIOR module analysis in software SPSS Clementine 17.0 was used to analyze the relevance degree between FBG,DD,PT,APTT and IgA,IgM,IgG,C3,C4,CRP,ESR and UA.Results:①Coagulation index value analysis showed that in 324 GA cases,FBG increased in 162 cases（50.00%）,DD increased in 136 cases（41.98%）.②Correlation analysis showed that FBG was positively correlated with IgA,C3,C4,CRP and ESR（P < 0.05）;DD was positively correlated with CRP and ESR（P < 0.05）;PT was positively correlated with IgG and CRP（P < 0.05）.③Logistic regression analysis showed that C3,C4,CRP and ESR were the risk factors for the increase of FBG;IgG,CRP and ESR were the risk factors for the increase of DD;IgM was the risk factor for the decrease of APTT.④The relevance results showed that the minimum confidence level was 80%,and the minimum support was 20%.CRP,ESR,C3,C4 were the indicators with higher correlation with the rise of FBG,and CRP,ESR,C3,C4,UA were the indicators with higher correlation with the rise of DD.Conclusion:Gouty arthritispatients have hypercoagulable state,mainly manifested in the increase of FBG and DD.The coagulation indexes are correlated with immunity,inflammation and uric acid.Immune and inflammatory indexes are the risk factors of abnormal coagulation indexes,and their changes may participate in the occurrence and development of gouty arthritis.

　　【Keywords】 gouty arthritis;coagulation indexes;uric acid;hypercoagulable state;data mining