Fedorovych K.M., Yatsyshyn R.I.

Summary. The purpose of the study was to analyze platelet indices (TI) in patients with rheumatoid arthritis (RA); to confirm the process of platelet activation in the pathogenesis of inflammation in RA, as well as determine the relationships between TI and the index of RA activity and their evaluation. Object and methods. The study included 60 patients diagnosed with RA. The control group consisted of 25 healthy people, representative of age and sex. All patients underwent standard clinical and laboratory analysis. TI were analyzed from a detailed blood count, including platelet count (Plt), mean platelet volume (MPV), platelet distribution width (PDW), platelet count (PCT), and platelet to lymphocyte ratio (PLR). Based on DAS-28, 4 subgroups were formed (DAS28 <2.6 — first subgroup; 2.6<DAS28≥3.2 — second subgroup; 3.2>DAS28≥5.1 — third subgroup; DAS28 >5.1 — fourth subgroup). Results. ESR and CRP, as well as subjective assessment of pain intensity by VAS were highest in the fourth subgroup of the experimental group and differed between the experimental group and control patients (p<0.05). By analogy, PCT was higher in all four subgroups of patients compared with the control group (p<0.05). The PLR ​​index showed a similar upward trend in severe inflammation, and individuals included in the fourth subgroup showed the highest value of this index (212.86±89.54, p<0.05). In contrast, MPV and PDW parameters in patients with severe RA activity (DAS28 >5.1) were lower compared to patients in remission (9.457±0.843 and 18.631±0.735 vs 9.832±0.827 and 18.809±0.673, respectively). We also found a positive correlation between PCT and PLR and ESR and PSA (r=0.69 and r=0.71; r=0.65 and r=0.72, respectively) and a negative correlation between MPV, PDW and mentioned indicators of inflammation (r=–0.59 and r=–0.67 and r=–0.64 and r=–0.73, respectively). Conclusions. It was confirmed that TI correlates with indicators of RA activity, which, in turn, allows to consider TI as additional markers of inflammatory activity in RA.

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