类风湿关节炎心血管损害的相关性研究  

Association of rheumatoid arthritis with cardiovascular involvement

作　　者：周婷[1,2] 吴侗[2] 龙丽[2] 周彬[2] 

机构地区：[1]川北医学院,四川南充637000 [2]四川省医学科学院.四川省人民医院风湿免疫科,四川成都610072

出　　处：《实用医院临床杂志》2015年第5期81-83,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨类风湿关节炎(rheumatoid arthritis,RA)患者心血管损害的超声表现及相关因素。方法 2013年12月至2014年6月住院RA患者168例,采用超声心动图检测患者有无心血管损害,分为心血管损害组(A组)62例和无心血管损害组(B组)106例,比较两组各临床指标的差异并对A组血脂与炎性指标间关系进行相关性分析。结果 A组主要表现为左室舒张功能不全32例、瓣膜损害37例、心包积液9例、房室增大14例、心肌运动异常13例、主动脉硬化17例。两组年龄、血沉(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、抗环瓜氨酸肽抗体(抗CCP)、高密度脂蛋白(HDL-C)之间差异有统计学意义(P<0.05)。HDL-C与ESR、CRP之间存在负相关(r分别为-0.449和-0.312,P<0.05),而LDL-C、甘油三酯(TG)、总胆固醇(TC)与炎性指标间未见明显的相关性。结论 RA并发心血管损害比较常见,超声心动图在诊断RA心血管损害中有重要价值。HDL-C与ESR、CRP之间存在负相关关系。Objective To investigate the echocardiography of cardiovascular damage in rheumatoid arthritis （RA）and the related risk factors. Methods One hundred and sixty-eight RA hospitalized patients from December 2013 to June 2014 were enrolled in this study. The patients were divided into cardiovascular involvement group（ group A, n = 62）and non cardiovascular involvement group （group B, n = 106）. The clinical parameters were compared between the two groups and relationship between blood lipid and inflammatory indexes in the group A was analyzed. Results In the group A, cardiovascular damage mainly were left ventricular diastolic dys- function （ n = 32 ）, cardiac valve disease （ n = 37 ）, pericardial＇effusion （ n = 9 ）, left atrial and left ventricular enlargement （ n = 14 ）, myo- cardial motion abnormalities （n = 13 ）, and aortic artery calcification （n = 17）. There were significant difference in age, erythrocyte sedi- mentation rate （ ESR）, C -reactive protein （ CRP）, rheumatoid factor （ RF）, anti-cyclic citnfilinated peptide （ anti-CCP ） antibody and highdensity lipeprotein cholesterol（HDL-C） between the two groups （P 〈 0.05 ）. There was a negative correlation among low-density lipe- protein cholesterol （LDL-C）, ESR and CRP（r=-0. 449 and-0. 312, P 〈 0. 05, respectively）while there was no obviously correlation among LDL-C, triglyceride（TG） and total cholesterol （TC）. Conclusion It is common that RA is complicated with cardiovascular damage. The echocardiography has a great value in the diagnosis of cardiovascular involvement in patients with RA. There is a negative correlation between HDL-C and ESR and between HDL-C and CRP.

关 键 词：类风湿 关节炎 心血管损害 超声心动图 

分 类 号：R593.22[医药卫生—内科学]