Kumeda Yasuro, Inaba Masaaki, Goto Hitoshi, Nagata Mayumi, Henmi Yasuko, Furumitsu Yutaka, Ishimura Eiji, Inui Kentaro, Yutani Yasutaka, Miki Takami, Shoji Tetsuo, Nishizawa Yoshiki
Division of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
Arthritis Rheum. 2002 Jun;46(6):1489-97. doi: 10.1002/art.10269.
To determine whether arterial wall thickening is advanced in rheumatoid arthritis (RA) patients compared with healthy controls by measuring the intima-media thickness (IMT) of the common carotid and femoral arteries, and to evaluate the factors associated with arterial IMT in patients with RA.
We studied 138 RA patients and 94 healthy controls (matched for age, sex, and other major risk factors for atherosclerosis). IMT was measured on digitized still images of the common carotid and femoral arteries obtained by high-resolution ultrasonography (10-MHz in-line Sectascanner). Laboratory variables relevant to RA activity were measured by routine methods. The degree of RA progression was assessed by scoring (Larsen method) metacarpophalangeal (MCP) joints on hand radiographs. Activities of daily living were determined by a modified Health Assessment Questionnaire (M-HAQ) score, and physical activity levels were assessed by ultrasound measurement of the calcaneus (expressed as the osteo-sono assessment index [OSI] Z score).
Common carotid and femoral artery IMTs were significantly higher (P < 0.05) in RA patients (mean +/- SD 0.641 +/- 0.127 and 0.632 +/- 0.125 mm, respectively) compared with controls (0.576 +/- 0.115 and 0.593 +/- 0.141 mm, respectively). Multiple regression analysis revealed a significant association between RA and the common carotid artery IMT. Moreover, the common carotid artery IMT in RA patients was positively associated with disease duration, the MCP joint Larsen score, and the M-HAQ score, and was negatively associated with the calcaneus OSI Z score. No significant association was found between corticosteroid treatment and common carotid artery IMT.
RA patients exhibited greater thickness of the common carotid and femoral arteries than healthy controls. The duration and severity of RA and decreased activities of daily living, but not corticosteroid treatment, were independently associated with the increased arterial wall thickness.
通过测量颈总动脉和股动脉的内膜中层厚度（IMT），确定类风湿关节炎（RA）患者与健康对照相比动脉壁增厚是否更严重，并评估RA患者中与动脉IMT相关的因素。
我们研究了138例RA患者和94例健康对照（在年龄、性别和其他主要动脉粥样硬化危险因素方面相匹配）。通过高分辨率超声（10MHz线阵Sectascanner）获得的颈总动脉和股动脉数字化静态图像测量IMT。通过常规方法测量与RA活动相关的实验室变量。通过对手部X线片上的掌指（MCP）关节进行评分（Larsen法）评估RA进展程度。通过改良健康评估问卷（M-HAQ）评分确定日常生活活动能力，并通过超声测量跟骨评估身体活动水平（表示为骨声评估指数[OSI]Z评分）。
与对照组（分别为0.576±0.115和0.593±0.141mm）相比，RA患者的颈总动脉和股动脉IMT显著更高（P<0.05）（分别为平均±标准差0.641±0.127和0.632±0.125mm）。多元回归分析显示RA与颈总动脉IMT之间存在显著关联。此外，RA患者的颈总动脉IMT与病程、MCP关节Larsen评分和M-HAQ评分呈正相关，与跟骨OSI Z评分呈负相关。未发现皮质类固醇治疗与颈总动脉IMT之间存在显著关联。
RA患者的颈总动脉和股动脉厚度比健康对照更大。RA的病程和严重程度以及日常生活活动能力下降，但不是皮质类固醇治疗，与动脉壁厚度增加独立相关。
