We went to the hospital to do the test form we got and showed it to the doctor, who wouldn't say anything after most of the cases, or "very good, good." However, when we go home and look closely, we will find some up and down arrows, compared with the normal value attached to the back, the high and low are not in the normal value range, and some even red logos, it feels bad at once: Is this really no problem?
It should be said that as long as it is not valued by rheumatologists, there is generally no big problem, at least for the time being, there is no need to intervene, and then say after the next examination and comparison.
Here it is mentioned that rheumatologists and non-rheumatologists may have some differences in the judgment and evaluation of the examination results of rheumatoid patients, and our examination results should be shown to rheumatologists.
The result of the inspection item we did, compared with the normal value, even if there is a difference of "1", as long as it is out of range, the arrow is marked, which is the setting of the instrument rule.
In fact, in terms of condition and physical function, there are several numerical differences, which is a very normal thing, not equal to any problem. What's more, during the testing process, the test results will also be affected by many factors, such as temperature, specimens, operation, instruments and so on. Therefore, the numerical value of human biochemical indicators plays an important role in the clinic as a reference value, rather than exceeding the normal range and having arrows up and down must be a problem with the physical condition.
When the results of a certain examination exceed the normal value, some do not need to worry and do not need any disposal measures; some need further observation, and do not need to be treated at present; and some show obvious problems and need to take immediate measures. For the first two cases, the doctor generally does not say anything to the patient, that is, "good, very good"; and in the third case, the doctor will definitely talk to the patient and take corresponding measures.
For us patients, see the up and down arrows, do not worry too much, and fear repeated diseases, new problems in the body. Standardized monitoring of drug side effects is necessary for the second situation, and side effects can be detected in time.
In addition, long-term standard inspection and monitoring can dynamically show the change trend of detection indicators, which is of great significance for us to grasp the disease situation, drug effect, drug side effects, and visceral function. Therefore, each test order needs to be kept properly, and it is more valuable if it can be checked and recorded for important indicators.
Blood routine
Blood routines are the most prone to arrows, and for rheumatoid patients, white blood cells are an important indicator of bone marrow suppression side effects monitored during medication. During treatment, if the test results are not too much lower than normal, the bone marrow suppression side effects of the drug are present, but they do not necessarily need to intervene, sometimes taking the drug for a period of time, the side effect may be reduced, and the white blood cells return to normal.
High white blood cells are also common. If there are hormones in the treatment drug, it is normal to have higher white blood cells; if it is a cold, trauma, etc., it is normal to have higher white blood cells.
In the test list, neutrophils, lymphocytes, monocytes, eosinophils, basophils and other categories of items, in fact, there is a mutual influence effect, one of which is increased at the same time accompanied by a decrease in other or another, although the arrow is more, but only reflects the same situation. Especially in the presence of infections, fluctuations in neutrophils, monocytes, lymphocytes, etc. are more common, and these do not require us to worry about it ourselves.
Erythrocyte-related indicators are closely related to the inflammatory activity of rheumatoid arthritis, and the inflammatory activity affects red blood cells, which are generally commonly seen in cases where red blood cell individuals (volume) become smaller, hemoglobin decreases, and hemoglobin concentration decreases. This condition is reversible, and once rheumatoid arthritis inflammation is controlled, after some time, it will normal on its own. There are also indicators such as platelet width associated with inflammation, and inflammation generally does not affect platelet values.
Urinalysis
The urine routine value is also a test list that is prone to abnormalities, and it is more marked by "+, -". If white blood cells appear alone, there is no red blood cell, urine protein concomitant appearance, generally has nothing to do with kidney function, urethral inflammation is more likely, doctors generally recommend "drink more water". When there is inflammation of the urethra and kidneys, white blood cells and red blood cells can appear at the same time. The simultaneous occurrence of leukocytes, proteins, and red blood cells increases the likelihood of renal function impairment, and further renal examination is required.
Urine protein is an indicator of kidney function is relatively close, the more "+" the case is worse, in patients with lupus erythematosus, taking drugs with obvious kidney side effects, need to pay attention to urine protein. But it does not necessarily mean that there is a problem as soon as the plus sign appears, and if the doctor thinks that there is no problem and does not need further examination and treatment, then there is no need to worry about anything.
The appearance of red blood cells, sometimes may be because of the relationship between menstruation and leave, which is false positive; when taking a drug, red blood cells appear, you need to pay attention to the kidney side effects of the drug, some anti-inflammatory and analgesic drugs can cause the appearance of red blood cells, should be changed medication. Red blood cells in the urine are only a cursory tip, and doing a red blood cell morphological examination can further determine the cause of the appearance of red blood cells, and if necessary, the doctor will arrange it.
Urinalysis routine examination is sometimes affected by factors such as less urine caused by drinking less water at that time, hot weather, etc., and long retention time in the urine body, which is also a relatively common factor when the patient is treated, not caused by diseases or drug side effects.
Liver and kidney function
The increase in renal function indicators is generally not a good phenomenon, and more professional examinations are needed. Decreased creatinine and uric acid, general problems are not large, may be related to malnutrition, less exercise and so on.
In terms of liver function, transaminases are sensitive indicators, the first use of a drug, to pay attention to the "transient transaminases elevated" situation, generally do not need intervention; if the value increases more than 3 times, generally need to stop the drug, patients may not be suitable for the drug. If there is an increase in transaminases during taking the drug, the value is not too high, and it is necessary to pay attention to the side effects of the drug, it is best to do a liver B ultrasound; if the value is increased a lot, there may be liver diseases and further examination is needed.
The above situations refer to the premise of standardizing the monitoring of liver and kidney function, and the situation of non-standard monitoring is not discussed.
Erythrocyte sedimentation rate (ESR) immunological indicators
Erythrocyte sediment rate is an indicator of the degree of activity that reflects inflammation, and in terms of disease monitoring, the function of C-reactive protein is basically the same, and it is generally possible to do a erythrocyte sediment rate.
Immunological indicators are high, some patients do not change much in treatment, or even elevated in treatment, if these conditions occur, there is no need to worry about it, or it is relatively normal.
In standardized treatment, doctors will pay attention to these indicators, but it is not necessarily possible to reduce these indicators, and we do not necessarily need to chase after the doctor and ask "Why didn't so-and-so decrease?" Honestly, this question is more difficult to answer, or even impossible to answer.
Source: ShaRuyin Space
Edited by: Yeah Reviewer: Xiao Ran