类风湿关节炎患者并发心血管疾病的危险因素  

Risk factors for cardiovascular disease in patients with rheumatoid arthritis

作　　者：李玉洁 姚炎炎 汤婧雯 胡艳敏 朱慎慎 李琳琳[2] 吴照科[1] LI Yujie;YAO Yanyan;TANG Jingwen;HU Yanmin;ZHU Shenshen;LI Linlin;WU Zhaoke(Department of Gerontology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,Henan,China;College of Public Health,Zhengzhou University,Zhengzhou 450001,Henan,China)

机构地区：[1]郑州大学第二附属医院老年医学科,河南郑州450003 [2]郑州大学公共卫生学院,河南郑州450001

出　　处：《中国现代医生》2025年第10期20-24,共5页China Modern Doctor

摘　　要：目的探讨类风湿关节炎(rheumatoid arthritis,RA)并发心血管疾病(cardiovascular disease,CVD)的危险因素。方法收集2023年1月至2024年9月于郑州大学第二附属医院住院的225例RA患者的临床资料,根据是否并发CVD将患者分为CVD组(n=50)和非CVD组(n=175)。采用单因素和多因素Logistic回归分析RA患者并发CVD的危险因素。结果单因素Logistic回归分析结果显示,年龄、血细胞比容、红细胞体积分布宽度(red cell volume distribution width,RDW)、红细胞沉降率、中性粒细胞与高密度脂蛋白比值(neutrophil to high density lipoprotein ratio,NHR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)均是RA患者并发CVD的影响因素(P<0.05);多因素Logistic回归分析结果显示,年龄、RDW、NHR、PLR均是RA患者并发CVD的危险因素(P<0.05)。受试者操作特征曲线分析结果显示,年龄、RDW、NHR、PLR诊断RA患者并发CVD的曲线下面积(area under the curve,AUC)分别为0.844、0.797、0.572、0.713。四项指标联合诊断的AUC为0.898。结论RA患者并发CVD的风险受多种因素影响,联合年龄、RDW、NHR及PLR可提高RA患者并发CVD的早期诊断效能。Objective To investigate the risk factors for cardiovascular disease(CVD)in patients with rheumatoid arthritis(RA).Methods Clinical data of 225 patients with RA admitted to the Second Affiliated Hospital of Zhengzhou University from January 2023 to September 2024 were collected,and the patients were divided into CVD group(n=50)and non-CVD group(n=175)according to whether they were complicated by CVD.Univariate and multivariate Logistic regression was used to analyze the risk factors of CVD in RA patients.Results Univariate Logistic regression analysis showed that age,hematocrit,red cell volume distribution width(RDW),erythrocyte sedimentation rate,neutrophil to high density lipoprotein ratio(NHR)and platelet to lymphocyte ratio(PLR)were all influencing factors for CVD in RA patients(P<0.05).Multivariate Logistic regression analysis showed that age,RDW,NHR and PLR were all risk factors for CVD in RA patients(P<0.05).The results of receiver operating characteristic curve analysis showed that the area under the curve(AUC)of age,RDW,NHR and PLR diagnosed CVD in RA patients were 0.844,0.797,0.572 and 0.713,respectively.The combined diagnosis AUC of four indexes was 0.898.Conclusion The risk of CVD in RA patients is influenced by many factors,and the combination of age,RDW,NHR,and PLR can improve early diagnosis of CVD in RA patients.

关 键 词：类风湿关节炎 心血管疾病 中性粒细胞 血小板 高密度脂蛋白 

分 类 号：R593.22[医药卫生—内科学] R541[医药卫生—临床医学]