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Ревматоидный артрит какие анализы нужно сдать

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17 августа 2019

Артрит – серьезное заболевание, которое склонно к прогрессированию. Оно распространено среди людей любой возрастной категории. Несвоевременное лечение способствует развитию осложнений, которые тяжело поддаются терапии. В некоторых случаях симптоматика артрита выражена слабо, поэтому многие не замечают, как быстро развивается патология. Анализы на ревматоидный артрит рекомендуется сдавать при обнаружении первой симптоматики.

При каких симптомах показано обследование

Сдавать анализы на ревматоидный артрит необходимо при появлении следующих симптомов:

  • Появление суставной скованности, которая наблюдается длительное время.
  • Очаги воспаления проявляются симметрично.
  • Появление подкожных уплотнений, которые являются ревматоидными узелками.
  • Появление покраснения и отечности на пораженном участке.

Общий клинический анализ крови

Высокий показатель СОЭ сигнализирует о проблеме

Многих интересует, какие анализы сдавать на ревматоидный артрит. Начинать диагностику необходимо с общего анализа крови. Состав крови человека меняется в зависимости от происходящих процессов. При ревматоидном артрите клинический анализ покажет следующее:

  • Понижены криоглобулины.
  • Понижен гемоглобин, состояние характеризуется как умеренная анемия.
  • Повышены лейкоциты.
  • Незначительно повышена скорость оседания эритроцитов.

При высоких показателях СОЭ необходимо провести дополнительную диагностику на выяснение сторонних заболеваний. Артрит не характеризуется слишком высоким уровнем скорости оседания эритроцитов. Если показатель превышает 40 % от установленной нормы, то это говорит о наличии серьезного воспалительного процесса в организме, в некоторых случаях высокие показатели СОЭ являются следствием злокачественных новообразований.

Расшифровка анализа крови поможет пациенту ориентироваться в результатах диагностического исследования. Для выявления артрита достаточно обратить внимание на несколько показателей и их допустимую норму.

Показатели нормы
109-128
260-330
4-10
3.5-5.2
73-101
1-30 (в зависимости от возрастной категории и пола)

Показатели сильно выходят за пределы нормы в период обострения артрита. Острая стадия характеризуется сильными болевыми ощущениями.

Особую важность имеет биохимический анализ крови при ревматоидном артрите. Диагностировать заболевание помогают следующие показатели:

  • Повышены сиаловые кислоты.
  • Увеличено количество фибриногенов.
  • Большое количество С-реактивного белка.

Увеличенные сиаловые кислоты говорят о наличии воспалительного процесса. В норме они не превышают 2,30 ммоль/л. Даже незначительное отклонение в большую сторону говорит о начале развития ревматоидного артрита. Повышенный уровень фибриногенов характеризует не только наличие артрита, но и высокую вероятность образования тромбов.

С-реактивный белок увеличивается при любых воспалительных процессах в организме. Его повышенный уровень не всегда говорит о развитии ревматоидного артрита. Биохимия позволяет оценить общее состояние пациента и установить наличие сопутствующих заболеваний.

Анализ на АЦЦП

Анализ на АЦЦП обязательный при ревматоидном артрите

АЦЦП – определение титра к циклическому цитруллинированному пепдиду. Данный анализ позволяет диагностировать артрит на самых ранних стадиях. Анализ на АЦЦП при ревматоидном артрите является обязательным, он может выявить заболевание, даже если показатели по другим исследованиям находятся в пределах нормы.

АЦЦП вырабатываются в крови на самом раннем этапе развития артрита. В этот период симптомы еще отсутствуют, но уже можно диагностировать заболевание. На сегодняшний момент это исследование считается одним из самых достоверных.

Цитруллин вырабатывается, когда обменные процессы в организме функционируют в нормальном режиме. Под влиянием ревматоидного артрита изменяется ферментный состав крови, поэтому пептид цитруллина воспринимается как чужеродный объект. Иммунная система начинает работать в усиленном режиме, производя антитела, направленные на уничтожение цитруллина. Анализ АЦЦП способен определить наличие цитруллина в крови, это позволяет выявить начало артрита на самых ранних стадиях.

Анализ на РФ (ревматоидный фактор)

Анализ на РФ является вспомогательным

Ревматоидный фактор – аутоиммунное антитело, превращающееся в аутоантиген, после чего связывается со своими фрагментами антител. При поступлении в кровь соединяются с вирусами и бактериями. Ревматоидный фактор является показателем того, что поражение достигло периартикулярных тканей. Кроме поражения суставов возможны следующие проявления:

  • Развитие заболевания почек и мочеполовой системы.
  • Нарушения зрительной функции.
  • Поражения центральной нервной системы.
  • Изменения в формуле крови.

При наличии ревматоидного фактора пациент может испытывать приступы лихорадки, начинается процесс похудения и мышечная дистрофия.

Подтвердить или опровергнуть наличие ревматоидного артрита помогают дополнительные диагностические меры. Для определения РФ существует несколько методик.

Название методики Склеивание ИГ класса lgG с ревматоидном фактором на латексе

Исследование синовиальной жидкости более точно выявляет наличие артрита

Среди анализов при подозрении на ревматоидный артрит особое внимание уделяется исследованию синовиальной жидкости.

Синовиальная жидкость является одним из важных компонентов суставов. Она выполняет множество функций – локомоторную, метаболическую, трофическую и барьерную. Данные функции влияют на нормальное физиологическое состояние сустава.

Синовиальная жидкость способна отражать любые нарушения, которые касаются суставов. Она быстро реагирует на любые изменения в клеточном составе. В некоторых случаях среди анализов на ревматоидный артрит будет достаточно исследования синовиальной жидкости. При диагностике ее распределяют в 3 пробирки для того, чтобы провести три типа исследования:

  1. Цитологическое.
  2. Бактериологическое.
  3. Химико-микроскопическое.

Исследование синовиальной жидкости проходит по следующим этапам:

  1. Рассмотрение физических свойств (цвета, объема, вязкости, уровня pH, мутности)
  2. Исследование цитологии.
  3. Поляризационная микроскопия.
  4. Химическое исследование.

При необходимости проводят дополнительные обследования. При исследовании синовиальной жидкости в некоторых случаях оценивается уровень глюкозы, который помогает определить наличие воспалительных процессов в суставах. Уровень глюкозы уменьшается, если в суставах развивается воспаление.

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Этот метод используют во многих медицинских учреждениях. Для подтверждения диагноза необходимо провести дополнительные исследования, так как нарушенные состояния синовиальной жидкости не всегда указывают на артрит. Это может говорить и о других заболеваниях суставов.

Другие методы диагностики ревматоидного артрита

Рентгенография показывает дегенеративные изменения сустава

Выявить ревматоидный артрит помогают и другие методики. Для наиболее эффективной диагностики рекомендуется использовать их только в комплексе с основными методами.

В некоторых случаях пациентам назначается рентгенография, но на начальных этапах заболевания проводить ее нецелесообразно. По мере прогрессирования заболевания рентген позволяет рассмотреть околосуставной остеопороз или костную эрозию. Они станут заметны на рентгеновском снимке на 3-4 стадии заболевания. Рентгенография также позволяет оценить степень повреждения хрящей. Рентген суставов необходимо делать не единожды, а на протяжении всего процесса лечения. Это позволит оценить правильность подобранной терапии и в случае необходимости скорректировать ее.

Кроме этого, пациентам назначают общий анализ мочи. Он позволяет исключить заболевания мочеполовой системы, а также оценить общее состояние больного. Ревматоидный артрит оказывает влияние не только на суставы, но и на работу многих внутренних органов. Заболевание в запущенной стадии провоцирует воспаление почек и почечную недостаточность.

Биопсия тканей назначается в редких случаях. Биопсия рекомендована в целях рассмотрения структуры клеток и их изменений. Также она помогает оценить размер ткани и количество ворсинок, которые отложены на мембранах фибрина.

При затруднениях в постановке диагноза пациенту рекомендовано комплексное обследование, включающее в себя магнитно-резонансную томографию. Она позволяет исключить вероятность онкологических процессов в тканях.

Если симптоматика не имеет ярко выраженных проявлений, то для точного диагноза необходимо всестороннее обследование пациента.

Анализы на ревматоидный артрит обязательны при проявлении симптомов патологии и для дифференциального обследования. Ревматоидный артрит — аутоиммунное заболевание, сопровождающееся воспалением, симптомы которого настолько расплывчаты и неспецифичны, что без дифференциальных исследований уточнить диагноз не представляется возможным. Какие анализы являются специфичными, а какие имеют значение только при рассмотрении совокупности всех показателей?

Значимость лабораторных исследований

При уточнении диагноза такого сложного вида патологии анализы при ревматоидном артрите можно разделить на:

  • специфические — позволяющие с высокой степенью достоверности подтвердить или опровергнуть предварительный диагноз;
  • неспецифические — выявляют присутствие отдельных признаков и только в совокупности подтверждают диагноз.

Как правило, ревматоидный артрит диагностируется лишь на 7–8 год после его «дебюта». При этом у более 30% больных на разных стадиях развития заболевания ставят ошибочный диагноз. Особенно часто с диагностическими трудностями сталкиваются при попытке ранней диагностики патологии в возрастной группе пациентов до 30 лет. В начальной стадии прогрессирования заболевания инструментальные исследования имеют отрицательный результат. Поэтому разработка методов лабораторной диагностики патологии на максимально ранней стадии имеет большое значение.

Анализ крови при ревматоидном артрите помогает обнаружить циркулирующие аутоантитела и маркеры острой фазы воспалительного процесса. Специфическим анализом является определение ревматоидного фактора и выявление антител к циклическому цитруллинированному пептиду (АЦЦП). Именно исследование на АЦЦП стало передовым шагом в диагностике ранних форм ревматоидного артрита и определении патологии при серонегативной форме заболевания или при отсутствии выраженных симптомов.

По данным исследования НИИР РАМН, у пациентов с выявленным Р-фактором признаки ревматоидного артрита отмечались уже через год после проведенного исследования у 56% обследованных. Среди тех, у кого результат был отрицательным, через тот же период времени патология развилась у 44%.

В то время как при позитивном результате на АЦЦП заболевание через год развилось у 70% обследованных, а при негативном — у 30%. Приведенные результаты убедительно доказывают высокую валидность, чувствительность и информативность метода, которым проводится исследование АЦЦП.

Маркеры патологического процесса

Неспецифическим исследованием на ревматоидный артрит является анализ на присутствие маркеров острого воспалительного процесса. Когда диагностируют ревматоидный артрит, анализ крови из пальца на СОЭ (РОЭ) показывает повышенный (по сравнению с нормой) результат. Величина интервала полученных показателей маркеров и их референсных значений свидетельствуют об активной фазе воспалительного процесса в организме.

Но позитивный результат отмечается не только при ревматоидном артрите, но и при других видах патологии, сопровождающихся воспалением. Вместе со скоростью оседания эритроцитов исследуют и другие показатели крови — уровень фибриногена, наличие и активность С-реактивного белка, количество серомукоида. Результат помогает определить стадию прогрессирования заболевания. Смешанный тест — анализ на СОЭ и «маркеры воспаления» только позволяет сузить круг патологий со схожими симптомами. На сегодняшний день критерии ARC/EULAR являются единственно достоверным способом установить правильный диагноз.

Обязательный диагностический комплекс

При подозрении на наличие патологии и для дифференциации ревматоидного артрита врач обязательно назначит следующие анализы:

  • крови: клинический, биохимический, иммунологический, АЦЦП;
  • общий мочи;
  • внутрисуставной жидкости;
  • биоптата суставной оболочки и др.

Анализ крови помогает определить факторы наличия ревматоидного артрита даже на стадии, предшествующей появлению симптомокомплекса. При исследовании клинического анализа факторов крови обращают внимание на следующие показатели, которые являются острофазовыми маркерами:

  • активность гемоглобина;
  • СОЭ;
  • лейкоцитарную формулу;
  • число тромбоцитов;
  • количество криоглобулинов.

Результаты этих исследований напрямую связаны со стадией, на которой находится патологический процесс в организме больного.

Расшифровка биохимических анализов

Биохимические исследования крови пациента проводятся для установления активности следующих составляющих:

  • гаптоглобина — белка острой фазы, который контролирует течение и прогрессирование воспалительного процесса;
  • фибриногена в плазме крови — при повышении активности указывает на воспаление и активную фазу аутоиммунного заболевания;
  • сиаловых кислот — при превышении является диагностическим и прогностическим признаком активного воспалительного процесса;
  • серомукоидов — сывороточных белков;
  • пептидов;
  • γ — глобулинов;
  • криоглобулинов (IgM, IgG, IgA и др.).

Повышение уровня всех перечисленных факторов крови свидетельствует о том, что в организме протекает острый воспалительный процесс. Эти же факторы определяют и во внутрисуставной жидкости. Кроме того, эти белки вырабатываются не только клетками печени, но и органами иммунной системы, что косвенно может свидетельствовать и об ее уровне.

Специфические и неспецифичесике тесты

Определение уровня АЦЦП является самым информативным из современных методов раннего диагностирования заболевания, так как антитела к циклическому цитруллинированному пептиду вырабатываются задолго до того, как больной почувствует первые симптомы заболевания. Разница между возможными и существующими сроками установления патологии составляет более 10-15 лет, что дает надежду на быстрое начало лечения, то есть еще до возникновения необратимых изменений в суставах.

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Так, например, в результате множества клинических исследований была установлена достоверная связь между наличием Р-фактора и внешним воздействием на организм внешних и внутренних факторов, что снижает прогностическую ценность этого показателя.

Диагностическая чувствительность тестов разная, поэтому для получения цельной картины анализируются результаты всех перечисленных исследований. Ниже в таблице приведены полученные в результате клинических исследований показатели чувствительности методов исследования:

Принятое сокращение Расшифровка Показатель чувствительности (%)
АМЦВ Аутоантитела к модифицированному цитруллинированному виментину 78
АЦЦП антитела к циклическому цитрулиннированному пептиду 77
IgМ РФ Р- фактор представленный иммуноглобулином IgМ 71
IgА РФ Р- фактор представленный иммуноглобулином IgА 43
АКА Антикератиновые антитела 43
ARA33 Антитела к ядерному антигену RA33 31
АНФ Антинуклеарный фактор 31

Обычно при подозрении на данную патологию должны сдаваться анализы АЦЦП и РФ. Но если они будут отрицательными, то может быть назначено углубленное обследование, которое включает АМЦВ и ARA33. Так, например, IgМ РФ определяется не только при остром воспалительном процессе, но и при злокачественных процессах в пожилом возрасте. Поэтому и разрабатываются комплексы анализов, которые помогут увеличить чувствительность методов исследования.

Иммунологические анализы проводят с помощью иммуноферментного анализа. В настоящее время апробируются и другие методы исследования, которые помогут повысить достоверность результатов и просчитать риск развития патологии еще до ее возникновения. Так, например, оцениваются методы генного, транскриптомного и протеомного анализов, которые позволяют проанализировать генетически обусловленные риски появления патологий суставов.

Интерпретация результатов анализов

Для того чтобы установить диагностические признаки заболевания, необходимо полученные результаты анализов сравнить с нормой или референсными значениями исследуемых показателей.

Одним из исследуемых показателей является уровень гемоглобина. Установлено, что при ревматоидной патологии происходит снижение активности эритроцитов и количества гемоглобина за счет укорочения периода жизни эритроцитов или нарушения функции их продукции костным мозгом. В норме уровень гемоглобина в крови взрослого человека должен составлять 120–160г/л, но при данной болезни пороговое значение составляет 110 г/л. При прогрессировании патологии — гораздо меньше.

Норма АЦЦП — 3 Ед/мл. При ревматоидном артрите значение этого показателя может колебаться в интервале 58–87 Ед/мл. Увеличение интервала свидетельствует о прогрессирующем процессе разрушения хрящевой ткани. Чем больше эта разница, тем сильнее выражен дегенеративный процесс. Норма АМЦВ составляет менее 20 Ед/мл. О патологии свидетельствует повышение показателя, которое уже через несколько лет после появления первых признаков может достигать 62–86 Ед/мл.

Негативным проведенный анализ на Р-фактор считается при показателе менее 25МЕ/мл. При серопозитивной форме патологии это значение может составлять 59МЕ/мл, а при серонегативном — 18МЕ/мл. Норма ARA 33 составляет менее 25 МЕ/мл, но при патологии уровень возрастает — 30-32МЕ/мл.

Примечательно, что наблюдается отличие в этих показателях при ревматоидном артрите (РА) и других воспалительных заболеваниях суставов, что позволяет дифференцировать РА от подагры, остеоартроза, эрозивного артрита и др. Нормы показателей, которые определяются при биохимическом анализе крови, составляют:

  • гаптоглобин — в крови 0,8-2,7 г/л, в моче 0,0–4,2 мг/л;
  • фибриноген — 2–4 г/л;
  • сиаловая кислота — 620–730 мг/л (2,0–2033 ммоль/л);
  • серомукоиды — 1,2–1,6 ммоль/л;
  • гамма-глобулин — 8–13,5 г/л .

Повышение этих показателей свидетельствуют не только о наличии воспалительного процесса. Так, например, увеличение количества сиаловых кислот возникает при разрушении коллагеновой ткани. Повышение количества гаптоглобина свидетельствует о процессе разрушения эритроцитов, характерном для данного заболевания.

Сравнение изменений составляющих протеинограммы помогает определить, на какой стадии находится патология, сколько времени прошло от возникновения дегенеративных нарушений. Сдать анализы требуется и для определения эффективности терапевтических методов, применяемых для лечения болезни.

Проходить исследования нужно при предрасположенности к данному заболеванию, а также при достижении возраста после 50 лет. Анализ полученных результатов и интерпретация их позволяют на начальных стадиях определить наличие заболевания или рассчитать с высокой степенью достоверности фактор риска.

Ревматоидный артрит – это тяжелая патология неясного происхождения, при которой разрушению подвергаются мелкие суставы и ткань, выполняющая соединительную функцию в них. Чаще всего заболевание распространяется на лодыжки, мелкие суставы в кистях, суставы колена.

Значимость лабораторных исследований

Ревматоидный артрит развивается практически бессимптомно, но продолжает прогрессировать разрушая суставы. Порой даже высококвалифицированные специалисты не в состоянии поставить верный диагноз, основываясь только на жалобах пациента.

Более активно патология проявляется у женского пола старше 30 лет, она может развиваться и у мужчин, но значительно реже.

Первыми признаками проявления данной патологии являются:

  • Возникновение боли в пораженном суставе.
  • Нарушение подвижности в суставах после сна.
  • Уплотнения в области сустава, или как их называют в медицине – ревматоидные узелки.
  • Беспричинная гипертермия.

Важно знать, что возникновение хотя бы одного из вышеперечисленных симптомов, это сигнал о возможном развитии ревматоидного артрита.

Дело в том, что при данной патологии, иммунная система человека начинает работать против организма, вырабатывая антитела не на чужеродный вирус или аллерген, а к собственному организму, в частности против клеток соединительной ткани.

Поэтому, так важно вовремя диагностировать патологию и незамедлительно лечить, так как в тяжелых стадиях, поражаются не только суставы, а также и легочная и кровеносная системы.

Какие же сдают анализы на ревматоидный артрит? Если человека беспокоят боли в суставах на протяжении нескольких недель, после консультации у ревматолога больной направляется на проведение ряда анализов.

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Лишь с их помощью возможно подтвердить либо опровергнуть диагноз. К основным анализам для диагностики заболевания относятся: общие и биохимические показатели крови, проба на ревмафактор, маркер на антинуклеарные антитела. Более подробно данные способы диагностики будут рассмотрены ниже.

Общий анализ крови

Для диагностики артрита важно изучить данные, полученные в результате проведения общего анализа. Кровь на ревматоидный артрит забирается у пациента исключительно утром, из пальца, натощак. Поговорим подробнее о показателях этого анализа.

Лейкоциты

Это клетки иммунной системы (их еще называют белыми клетками крови), которые защищают наш организм от чужеродных клеток, агентов. У заболевшего иммунная система по ошибке атакует свои же клетки соединительной ткани, разрушая суставы.

В следствии чего в крови появляется очень много частичек разрушенной ткани, которую лейкоцитам нужно обезвредить. Организм начинает вырабатывать лейкоциты в большом количестве. В итоге, при заболевании лейкоцитарная формула значительно превышает норму: более 4-9×109 г/л.

Гемоглобин

Это показатель состояния эритроцитов – красных клеток крови. Эритроциты перемещают кислород ко всем органам и тканям в организме. При заболевании, из-за длительного воспалительного процесса, синтез эритроцитов замедляется, у человека диагностируется анемия умеренного характера. У здорового человека гемоглобин равен 90-110 г/л.

Скорость оседания эритроцитов – один из самых важных показателей, указывающих на воспаление. После взятия крови на исследование, нормально то, что через некоторое время эритроциты выпадают в осадок (в норме для мужчин это 9 мм/ч, для женщин 14мм/ч).

С развитием воспаления, оседание эритроцитов происходит быстрее, и чем сильнее воспалительный процесс, тем быстрее это происходит. При развитии патологии, воспаление имеет хронический характер, в итоге СОЭ более высокая.

Биохимический анализ крови

Важно знать, что изменения показателей гемоглобина, лейкоцитов и СОЭ могут возникать и при других аутоиммунных заболеваниях воспалительного характера. Поэтому необходимо сдать биохимический анализ крови на ревматоидный артрит, в данном исследовании показатели более специфичны. Забор крови осуществляется из вены.

Фибриноген

Это специальный белок, который выполняет функцию свертывания крови. Показатели нормы у здорового человека – 1,9-3,8 г/л. У заболевшего показатели выше нормы. Связано это с тем, что иммунная система ускоряет выработку фибриногена для борьбы с воспалением в разрушенных суставах. Чем выше цифры фибриногена, тем прогрессивнее артрит.

Сиаловые кислоты

Это те самые частички разрушенных суставов, попавших в кровоток, с которыми лейкоциты не справились. В норме показатель сиаловых кислот равен – 1,8 ммоль/л. Чем выше показатель сиаловых кислот тем сильнее разрушены суставы.

Гаптоглобин

Гаптоглобин участвует в синтезе новых эритроцитов. Он состоит из свободного гемоглобина в крови, образовавшегося в результате отмирания эритроцитов. В результате чего показатели гаптоглобина растут выше 3 г/л.

К нетипичной причине воспаления относится наличие в крови у больного ревматическим артритом – С-реактивного белка. У здорового человека С-реактивный белок отсутствует или присутствует в очень низком количестве.

Ревматоидный фактор

Вместе с биохимическим и общим исследованием крови для выявления заболевания, также существуют: маркеры ревматоидного артрита, способные диагностировать заболевание.

Как мы уже говорили выше, иммунная система в норме вырабатывает иммуноглобулины, которые защищают наш организм, но при ревматоидном артрите вырабатываются еще особые иммуноглобулины, которые уничтожают не чужеродные клетки, а соединительную ткань своего же организма.

Одним из таких иммуноглобулинов является – ревматоидный фактор. Для определения наличия в крови ревмафактора используют так называемые «латекс-пробы». Чем больше иммуноглобулинов соединились с латексов, тем выше показатель ревмапробы, это около 50-100 МЕ/мл.

Антинуклеарные антитела

Это антитела, разрушающие соединительную ткань. В норме они не вырабатываются. Поэтому при обнаружении их в крови проба считается положительной и специалист смело дает заключение о наличии заболевания.

Все перечисленные анализы в своей совокупности помогают определить: антинуклеарные антитела, антиген комплекса гистосовместимости, LE-клетки и антикератиновые тела. Своевременная диагностика это первый и самый важный шаг к успешному лечению.

Другие методы

Ревматоидный артрит часто сопровождается заболеваниями почек, поэтому целесообразно кроме исследования крови провести анализ мочи для исключения амилоидоза.

Иногда доктора прибегают еще к одному методу диагностики – это исследование жидкости, находящейся в суставной полости (в медицине – синовиальная жидкость). При норме она должна быть без примесей, иметь легкий желтый оттенок.

При развитии заболевания синовиальная жидкость мутнеет, становится желто-зеленого цвета и вырабатывается в большом количестве, в связи с длительно текущим воспалительным процессом.

Подготовка к проведению анализов

Для достоверности результатов вышеперечисленных анализов следует соблюдать несколько важных правил:

  1. За 12 часов до проведения анализов не употреблять пищу, можно пить лишь простую воду.
  2. Исключить все вредные факторы, не употреблять алкоголь, не курить хотя бы за день до сдачи крови.
  3. Исключить всевозможные физические нагрузки.
  4. Не употреблять в пищу жареные и жирные продукты за 3 дня до исследования крови на ревматоидный артрит.
  5. По возможности прекратить прием всех медицинских препаратов за сутки.

Особенности проведения анализов у ребенка

В последнее время все чаще данный диагноз ставят именно детям. Правила проведения анализов на ревматоидный артрит у детей практически ничем не отличаются от взрослых. Единственная особенность существует для детей до 5 лет.

Перед проведением анализа ребенку нужно выпить 300 мл кипяченой воды за 30 минут.

Заключение

Записаться к врачу, работающему в Вашем городе можно прямо на нашем сайте.

Нужно обратить внимание на то, что ревматоидный артрит – это хронически протекающее заболевание, которое может давать рецидивы. Человеку с этим заболеванием в анамнезе, следует вести здоровый образ жизни, чтобы исключить воздействие неблагоприятных факторов на организм.

При первых признаках проявления заболевания, не стоит заниматься самолечением, необходимо своевременно обратиться к специалисту. Это поможет избежать развития опасных осложнений.

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