RF、抗CCP抗体、CRP及红细胞沉降率与伴类风湿关节炎的CHD患者心肌梗死的关联性  

The Correlation Between RF,Anti-CCP Antibody,CRP,Erythrocyte Sedimentation Rate and Myocardial Infarction in CHD Patients with Rheumatoid Arthritis

作　　者：李红艳 张瑾 伍树芳 张薇 LI Hongyan;ZHANG Jin;WU Shufang;ZHANG Wei(Rheumatology and Immunology Department,Nanjing Jiangning Hospital,Nanjing,211100,China)

机构地区：[1]南京市江宁医院风湿免疫科,江苏南京211100

出　　处：《标记免疫分析与临床》2025年第2期331-335,357,共6页Labeled Immunoassays and Clinical Medicine

基　　金：北京白求恩公益基金会(编号:JNYYHXKY202201)。

摘　　要：目的探讨外周血中类风湿因子(RF)、抗环瓜氨酸(CCP)抗体、C反应蛋白(CRP)及红细胞沉降率(ESR)与合并类风湿关节炎(RA)的冠心病(CHD)患者发生心肌梗死的关系。方法本研究设计方案采用病例对照研究方法,选取南京市江宁医院风湿免疫科2021年1月至2023年12月收治的204例合并RA的CHD患者,根据其是否发生急性心肌梗死将其分为梗死组72例(梗死组)、未发生急性心肌梗死的患者132例(非梗死组),检测两组患者的RF、抗CCP抗体、CRP、ESR及相关实验室指标,采用Logistic回归模型分析各种因素与患者发生心肌梗死的风险关系。结果梗死组患者的RF、抗CCP抗体、ESR、CRP测定值显著高于非梗死组患者,差异具有统计学意义(P<0.05);梗死组患者≥65岁患者占比、RA病程≥5.0年患者占比均显著高于非梗死组患者,差异具有统计学意义(P<0.05);梗死组和非梗死组患者的BMI、CHD病程、性别、吸烟、饮酒、合并高血压、合并糖尿病情况比较,差异均无统计学意义(P>0.05);梗死组患者血清IL-6水平显著高于非梗死组患者,梗死组患者血清HDL-C水平低于非梗死组患者,差异均具有统计学意义(P<0.05);梗死组和非梗死组患者的血清TG、TC、LDL-C、尿酸、Scr测定值比较,差异均无统计学意义(P>0.05);RF升高、抗CCP抗体升高、CRP升高、IL-6升高,RA病程延长是合并RA的CHD患者发生心肌梗死的独立危险因素(P<0.05)。结论合并RA的CHD患者发生心肌梗死受到多种因素的影响,其中RA病程延长且风湿相关因子、血清CRP水平升高都会显著增大患者发生心肌梗死的风险。Objective To investigate the relationship between rheumatoid factor(RF),anti-cyclic citrullinated peptide(CCP)antibody,C-reactive protein(CRP),and erythrocyte sedimentation rate(ESR)in peripheral blood and the occurrence of myocardial infarction in patients with coronary heart disease(CHD)complicated with rheumatoid arthritis(RA).Methods This study employed a case-control study design by selecting 204 patients with CHD complicated with RA admitted to the Department of Rheumatology and Immunology of Jiangning Hospital in Nanjing from January,2021 to December,2023.These patients were divided into an infarction group of 72 patients(infarction group)who developed acute myocardial infarction and a non-infarction group of 132 patients(non-infarction group)who did not develop acute myocardial infarction.RF,anti-CCP antibody,CRP,ESR,and relevant laboratory indicators were measured in both groups.Logistic regression models were performed to analyze the risk relationship between various factors and the occurrence of myocardial infarction.Results RF,anti-CCP antibody,ESR,and CRP in the infarction group were significantly higher than those in the non-infarction group(P<0.05).The proportions of patients aged≥65 years and those with an RA duration of≥5.0 years in the infarction group were significantly higher than those in the non-infarction group(P<0.05).There were no statistically significant differences in BMI,CHD duration,gender,smoking,alcohol consumption,hypertension,or diabetes between the infarction and non-infarction groups(P>0.05).The serum IL-6 level in the infarction group was significantly higher than that in the non-infarction group,while the serum HDL-C level in the infarction group was significantly lower than that in the non-infarction group(P<0.05).There were no statistically significant differences in serum TG,TC,LDL-C,uric acid,or Scr levels between the infarction and non-infarction groups(P>0.05).Elevated RF,elevated anti-CCP antibody,elevated CRP,elevated IL-6,and prolonged RA duration were identified

关 键 词：类风湿因子 抗环瓜氨酸抗体 C反应蛋白 红细胞沉降率 类风湿关节 冠心病 心肌梗死 

分 类 号：R593.22[医药卫生—内科学]