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リウマチ性関節炎は,大動脈脈波速度の増加と関連しており,これは抗腫瘍ネクロシス因子-アルファ療法によって減少します
Kaisa M Mäki-Petäjä1, Frances C Hall, Anthony D Booth
1Clinical Pharmacology Unit, University of Cambridge, Addenbrooke's Hospital, Box 110, Cambridge CB2 2QQ, United Kingdom.
Circulation
|September 6, 2006
まとめ
リウマチ性関節炎 (RA) 患者には硬直した大動脈があり,心血管疾患のリスクが増加します. 抗腫瘍死滅因子アルファ (TNF-alpha) 治療は,この大動脈の硬さを効果的に軽減し,炎症制御がRA患者にとって有益であることを示唆しています.
科学分野:
- 心血管医学 心血管医学
- レウマトロジーの病理学
- 血管生物学 血管生物学
背景:
- リウマチ性関節炎 (RA) は,部分的には大動脈の硬さが増加したため,より高い心血管リスクに関連しています.
- 大動脈の硬さは,心血管疾患による死亡率の独立した予測因子です.
- 伝統的なリスク要因は,RAにおける心血管疾患のリスクの増加を完全に説明できない.
研究 の 目的:
- RA患者で大動脈の硬さが上昇しているかどうかを判断するために.
- RAにおける炎症と大動脈の硬さとの関係を調査する.
- 抗腫瘍死滅因子アルファ (TNF-alpha) 療法によって大動脈の硬さが軽減できるかどうかをテストする.
主な方法:
- 大動脈脈波速度 (PWV) と増幅指数は77人のRA患者と142人の対照群で測定されました.
- 炎症マーカーと疾患活動が評価されました.
- PWVと内皮機能に対する抗TNFα療法の影響は,RA患者の9人に12週間にわたって評価されました.
主要な成果:
- RAの患者は,健康な個人と比較して,大動脈PWVが著しく高かった (P = 0.005).
- 大動脈PWVは,年齢,平均動脈圧,およびC反応性タンパク質レベルと独立して相関していました.
- 抗TNF-α療法により,大動脈PWVが有意に減少 (P<0.001) し,内皮機能が改善されました.
結論:
- RAは,現在の炎症に関連した,大動脈の硬直性の増加と関連しています.
- この増加した大動脈の硬さは,効果的な炎症制御で逆戻り可能なように見える.
- 抗TNF-α療法によって大動脈の硬さが正常化され,RAにおける心血管疾患のリスクを低減する戦略を示唆した.
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