RA的诊断难题

Rheumatoid arthritis (RA) is the chronic inflammation of your joints. The condition affects around130万成年人根据美国风湿病学院的说法。RA类似于许多其他疾病和疾病。这就是为什么通常需要时间诊断的原因。

如果您的对称关节有早晨的僵硬和疼痛，那么您和您的医生有一些侦探工作。你可以有：

  • RA
  • 骨关节炎
  • 癌症

或者，简而言之，您可能会有一个坏床垫。

血液测试对您是否患有RA并不提供简单的是或不答案。但是他们可以帮助您的医生诊断。血液测试缩小选择范围，并暗示您的疾病如何进展。

收到RA的诊断后，持续的血液检查将监测治疗中使用的药物的副作用。他们还可以帮助跟踪疾病的进展。

Once you leave a sample of your blood at the lab, it may be checked for these factors:

  • Rheumatoid factor (RF): RF antibodies collect in the synovium, or tissue lining of your joints. They are present in the blood of many people with RA.
  • Erythrocyte sedimentation rate (ESR): A high erythrocyte sedimentation rate may indicate inflammation in your joints.
  • C-reactive protein (CRP): This protein may also indicate inflammation in your joints.
  • 全血细胞计数(CBC): This includes hemoglobin and hematocrit tests, which may reveal anemia. This may also be associated with RA.

类风湿因子抗体聚集在关节的滑膜中。如果您患有另一种疾病，抗体也可以显示。最常见的抗体形式称为免疫球蛋白IgM。当该抗体附着在健康的身体组织上时，它会造成损害。

The RF test is not perfect for determining if you have RA. While many people with RA display this factor, some don’t. Also, some people who don’t have the condition test positive for RF due to other diseases or disorders, such as:

RF测试的结果将报告为每毫升单位（U/mL）或血液中抗体的浓度。血液中RF抗体的正常水平小于40至60 U/ml，或1:80的浓度。较高的数字表示阳性RF结果。

The higher the figure, the more likely you have RA. But it could also be an indication ofSjogren syndrome。那是一种自身免疫性疾病，会导致眼睛干燥和口干。

ESR测试也称为SED速率。它通过看到红细胞如何团结在一起来测量炎症。在此测试中，您的血液被放入试管中，以观察红细胞（红细胞）的速度流向底部。

表明炎症的蛋白质会导致红细胞粘在一起并滚动到管的底部。更快的沉积速率表明炎症更大。

This ring-shaped protein is produced by the liver as a result of inflammation. CRP doesn’t confirm RA. It reveals the severity of a condition rather than what specifically is wrong. The CRP test may be more sensitive than the ESR test.

如果您在RF测试中有假阴性，则ESR或CRP测试可能会提供类风湿关节炎的指示。

但是，任何自身免疫反应或细菌感染也可能升高CRP水平。这可能会使测试结果的解释变得复杂。

全血细胞计数is a routine test. It looks at your counts of white and red blood cells. The hematocrit test measures the volume of red blood cells. The hemoglobin test determines your body’s ability to carry oxygen.

低血红蛋白和血细胞比容结果（贫血）可能与类风湿关节炎有关。

Your healthcare providers will study your blood test results. If you have a combination of RF antibodies and symmetric joint pain, this may suggest RA. Joint pain is most typically found in the:

  • 手腕
  • 手
  • elbows
  • 肩膀
  • 脚踝
  • knees

显示关节损伤的X射线可以帮助确认诊断。您的医生还可能会定期要求X射线检查以监控疾病的进度。