类风湿关节炎患者发生心血管疾病的危险因素分析  

Analysis of risk factors for cardiovascular disease in patients with rheumatoid arthritis

作　　者：李运启 李正芳 吴雪 徐千禧 李婷婷 武丽君[2] LI Yunqi;LI Zhengfang;WU Xue;XU Qianxi;LI Tingting;WU Lijun(School of Medicine,Shihezi University,Shihezi 832061,China;不详)

机构地区：[1]石河子大学医学院,新疆石河子832061 [2]新疆维吾尔自治区人民医院风湿免疫科,新疆乌鲁木齐830001

出　　处：《山东医药》2025年第4期48-53,共6页Shandong Medical Journal

基　　金：新疆维吾尔自治区重点研发项目(2022B03002-1)。

摘　　要：目的分析类风湿关节炎(RA)患者发生心血管疾病(CVD)的危险因素。方法432例RA患者根据是否发生CVD分为观察组(145例,发生CVD)和对照组(287例,未发生CVD),采用单因素分析法及多因素Logistic回归分析法分析RA发生CVD的危险因素。结果两组年龄、性别、病程、吸烟史、饮酒史、高血压史、糖尿病史、身体质量指数、红细胞、血小板(PLT)、淋巴细胞、总蛋白、球蛋白(GLB)、白球比(A/G)、γ谷氨酰转移酶、尿素氮(BUN)、肌酐、尿酸、肌酸激酶同工酶、乳酸同工酶、钠离子、血清胱抑素C、同型半胱氨酸、D-二聚体(D-D)、25-羟维生素D3[25(OH)D3]、淋巴细胞/单核细胞和中性粒细胞/淋巴细胞(NLR)、肿胀关节数、免疫球蛋白G、免疫球蛋白M、高密度脂蛋白(HDL)、动脉硬化指数、干扰素γ(IFN-γ)、白细胞介素6、白细胞介素2、白细胞介素4、肿瘤坏死因子α水平比较,P均<0.05。多因素分析显示,年龄大、病程长、男性、患高血压及高血清GLB、BUN、IFN-γ、NLR、A/G、D-D水平和低血清PLT、HDL、25(OH)D3水平是RA发生CVD的独立危险因素(P均<0.05)。结论RA发生CVD的危险因素是年龄大、病程长、男性、患高血压及高血清GLB、BUN、IFN-γ、NLR、A/G、D-D水平和低血清PLT、HDL、25(OH)D3水平。Objective To analyze the risk factors for cardiovascular disease(CVD)in patients with rheumatoid ar-thritis(RA).Methods A total of 432 RA patients were divided into the observation group(145 cases,with CVD)and the control group(287 cases,without CVD)based on whether they developed CVD.The risk factors for CVD in RA were analyzed using univariate analysis and multivariate Logistic regression analysis.Results Significant differences were found in the age,gender,disease duration,smoking,alcohol consumption,history of hypertension,history of dia-betes,body mass index(BMI),red blood cells,platelets(PLT),lymphocytes,total protein,globulin(GLB),albu-min/globulin ratio(A/G),γ-glutamyl transferase(GGT),blood urea nitrogen(BUN),creatinine,uric acid,creatine kinase-MB(CK-MB),lactate dehydrogenase(LDH)isoenzyme,sodium ions,serum cystatin C,homocysteine,D-di-mer(D-D),25-hydroxyvitamin D3[25(OH)D3],lymphocyte-to-monocyte ratio(LMR),neutrophil-to-lymphocyte ratio(NLR),swollen joint count,immunoglobulin G(IgG),immunoglobulin M(IgM),high-density lipoprotein(HDL),atherosclerosis index,interferon-γ(IFN-γ),interleukin-6(IL-6),interleukin-2(IL-2),interleukin-4(IL-4),and tu-mor necrosis factor-α(TNF-α)levels between these two groups(all P<0.05).Multivariate analysis revealed that ad-vanced age,longer disease duration,male gender,presence of hypertension,and elevated serum levels of GLB,BUN,IFN-γ,NLR,A/G,and D-D,as well as low serum levels of PLT,HDL,and 25(OH)D3,were independent risk factors for the development of CVD in patients with RA.Conclusion The risk factors for the development of CVD in RA pa-tients include advanced age,longer disease duration,male gender,presence of hypertension,and elevated serum levels of GLB,BUN,IFN-γ,NLR,A/G and D-D,as well as low serum levels of PLT,HDL,and 25(OH)D3.

关 键 词：类风湿关节炎 心血管疾病 危险因素 年龄 病程 高血压 球蛋白 D-二聚体 25-羟维生素D3 

分 类 号：R593.22[医药卫生—内科学] R825.4[医药卫生—临床医学]