关节动脉样硬化在风湿性关节炎诊断后的前五年:一个横截面研究
Dionicio Angel Galarza-Delgado1, Jose Ramon Azpiri-Lopez2, Natalia Guajardo-Jauregui3
1Rheumatology Service, Internal Medicine Department, Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico.
Advances in rheumatology (London, England)
|July 28, 2023
概括
类风湿性关节炎 (RA) 患者在诊断后五年内,与健康个体相比, carotid 斑块和动脉样硬化率更高. 中度至高的疾病活性与RA中亚临床动脉样硬化风险的增加有关.
科学领域:
- 心血管医学 心血管医学
- 类风湿病学 类风湿病学
- 医疗成像医学成像
背景情况:
- 在风湿性关节炎 (RA) 诊断之前的全身炎症与更快的动脉样硬化有关.
- 早期的RA诊断对于了解长期心血管风险至关重要.
研究的目的:
- 为了比较冠状动脉斑块 (CP) 在RA患者的患病率在诊断后五年内与健康对照.
- 在早期的RA中识别与亚临床动脉样硬化相关的疾病特征.
主要方法:
- 一项涉及60名早期RA患者和60名匹配的健康对照者的横截面研究.
- 动脉超声波用于检测CP并测量动脉内膜介质厚度 (cIMT).
- 亚临床动脉样硬化被定义为存在CP和/或增加cIMT.
主要成果:
- 关节炎患者的CP (30.0%对11.7%),双边CP (18.3%对3.3%),增加cIMT (30.0%对6.7%) 和整体亚临床动脉样硬化 (53.3%对18.3%) 的患病率显著更高.
- 患有亚临床动脉样硬化症的RA患者年龄较大,血脂不良和中度至高的疾病活性率较高 (DAS28-CRP).
- 中度至高的疾病活动独立预测了亚临床动脉样硬化 (OR 6.11).
结论:
- 早期的RA诊断 (在五年内) 与亚临床动脉样硬化,包括心动脉斑块的更高患病率有关.
- 建议在诊断时对RA患者进行心血管风险的查.
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