类风湿关节炎合并心血管损害危险因素分析  

Analysis of risk factors for cardiovascular damage in rheumatoid arthritis

作　　者：李珊 王文巧 王惠 张岩 LI Shan;WANG Wen-qiao;WANG Hui;ZHANG Yan(Department of Rheumatology,Tangdu Hospital,Air Force Medical University,Xi’an 710038,Shaanxi,China)

机构地区：[1]空军军医大学唐都医院风湿免疫科,陕西西安710038

出　　处：《心脏杂志》2024年第3期302-306,共5页Chinese Heart Journal

摘　　要：目的分析类风湿关节炎(RA)合并心血管损害的实验室特点,并分析RA合并心血管损害的危险因素。方法纳入2015年1月~2021年12月于空军军医大学唐都医院风湿免疫科住院的RA合并心血管损害患者139例进行回顾性分析,纳入同期诊断RA未合并心血管损害患者154例作为对照组,对其性别、年龄、病程及实验室检查等结果进行统计分析。结果与RA未合并心血管损害组相比,RA合并心血管损害组病程长,年龄大(均P<0.01),而性别无统计学差异,BAR(P<0.01)、AST(P<0.01)、BUN(P<0.05)、Cr(P<0.05)及CysC(P<0.01)均升高,吸烟比例(P<0.05)及糖尿病比例(P<0.01)均升高。RA合并心血管损害组患者白细胞计数(r=0.182)、中性粒细胞绝对值(r=0.266)、血小板与淋巴细胞比值(r=0.372)、中性粒细胞与淋巴细胞比值(r=0.351)、红细胞沉降率(r=0.53)、尿素氮与血清白蛋白比值(r=0.169)、血清胱抑素(r=0.171)、补体C3(r=0.183)、纤维蛋白原(r=0.624)、纤维蛋白原降解产物(r=0.39)、D-二聚体(r=0.34)与C反应蛋白呈正相关(P<0.05),淋巴细胞绝对值(r=-0.22)、血清白蛋白(r=-0.523)、高密度脂蛋白胆固醇(r=-0.221)及血红蛋白(r=-0.186)与C反应蛋白呈负相关(P<0.05)。Logistic回归分析结果显示病程长、年龄大、AST升高、吸烟及糖尿病是RA合并心血管损害的危险因素。结论RA合并心血管损害患者病程长、年龄大、AST升高、吸烟及糖尿病是RA合并心血管损害的危险因素。AIM To analyze laboratory characteristics and risk factors of rheumatoid arthritis combined with cardiovascular damage.METHODS A total of 139 rheumatoid arthritis patients with cardiovascular damage who were hospitalized in the Department of Rheumatology and Immunology of Tangdu Hospital of Air Force Medical University from January 2015 to December2021 were retrospectively analyzed,and 154 rheumatoid arthritis patients without cardiovascular damage served as the control group.The gender,age,course of disease and laboratory examination results were statistically analyzed.RESULTS Compared with the RA group without cardiovascular damage,the RA group with cardiovascular damage had a longer course of disease,older age(all P<0.01),but there was no statistical difference between the sexes.BAR(P<0.01),AST(P<0.01),BUN(P<0.05),Cr(P<0.05),CysC(P<0.01),smoking(P<0.05),and diabetes(P<0.01)increased.White blood cell count(r=0.182),absolute neutrophil count(r=0.266),platelet to lymphocyte ratio(r=0.372),neutrophil to lymphocyte ratio(r=0.351),erythrocyte sedimentation rate(r=0.53),urinary nitrogen to serum albumin ratio(r=0.169),serum cystatin(r=0.171),complement C3(r=0.183),fibrinogen(r=0.624)Fibrinogen degradation products(r=0.39)and D-dimers(r=0.34)were positively correlated with C-reactive protein(P<0.05),while absolute values of lymphocytes(r=−0.22),serum albumin(r=−0.523),high-density lipoprotein cholesterol(r=−0.221),and hemoglobin(r=−0.186)were negatively correlated with C-reactive protein(P<0.05).Logistic regression analysis showed that long course of disease,old age,elevated AST,smoking and diabetes were risk factors for RA with cardiovascular damage.CONCLUSION The risk factors of RA with cardiovascular damage are long course of disease,old age,elevated AST,smoking and diabetes.

关 键 词：类风湿关节炎 心血管疾病 炎症 

分 类 号：R541[医药卫生—心血管疾病]