类风湿关节炎中的动脉粥样硬化：通过颈动脉超声获得的形态学证据。

Atherosclerosis in rheumatoid arthritis: morphologic evidence obtained by carotid ultrasound.

作者信息

Park Yong-Beom, Ahn Chul-Woo, Choi Hyon K, Lee Seung-Hoon, In Byung-Hyun, Lee Hyun-Chul, Nam Chung-Mo, Lee Soo-Kon

机构信息

Institute for Immunology and Immunological Diseases, BK21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, South Korea.

出版信息

Arthritis Rheum. 2002 Jul;46(7):1714-9. doi: 10.1002/art.10359.

DOI:10.1002/art.10359

PMID:12124853

Abstract

OBJECTIVE

Recent studies have suggested increased cardiovascular disease among patients with rheumatoid arthritis (RA). We undertook this study to obtain morphologic evidence of subclinical atherosclerosis in RA patients.

METHODS

We used high-resolution B-mode ultrasound to compare carotid artery intima-media wall thickness (IMT) between 53 postmenopausal women with RA and 53 controls matched by age, sex, and menopause status. No subject in either group had a history of atherosclerosis or its complications. We investigated the association between IMT and relevant clinical and therapeutic variables, including the impact of low-dose corticosteroid therapy (< or = 10 mg/day prednisolone).

RESULTS

The mean +/- SD IMT of the left and right common carotid arteries in RA patients was significantly greater than that in controls (0.77 +/- 0.09 mm versus 0.68 +/- 0.14 mm; P < 0.001). Early RA (duration < or = 1 year) was associated with lesser IMT than was RA of longer duration (0.72 +/- 0.03 mm versus 0.78 +/- 0.01 mm; P < 0.04). Prednisolone use was not associated with increased IMT (0.78 +/- 0.02 mm in nonusers versus 0.76 +/- 0.01 mm in users; P = 0.38).

CONCLUSION

Our data indicate that RA patients have an ultrasonic marker of early atherosclerosis consistent with an increased risk for atherosclerosis.

摘要

目的

近期研究表明类风湿关节炎（RA）患者的心血管疾病发生率有所增加。我们开展本研究以获取RA患者亚临床动脉粥样硬化的形态学证据。

方法

我们使用高分辨率B型超声比较了53名绝经后RA女性患者与53名年龄、性别和绝经状态相匹配的对照者的颈动脉内膜中层厚度（IMT）。两组中均无受试者有动脉粥样硬化病史或其并发症史。我们研究了IMT与相关临床及治疗变量之间的关联，包括低剂量皮质类固醇治疗（≤10mg/天泼尼松龙）的影响。

结果

RA患者左右颈总动脉的平均±标准差IMT显著大于对照组（0.77±0.09mm对0.68±0.14mm；P<0.001）。早期RA（病程≤1年）与病程较长的RA相比，IMT较小（0.72±0.03mm对0.78±0.01mm；P<0.04）。使用泼尼松龙与IMT增加无关（未使用者为0.78±0.02mm，使用者为0.76±0.01mm；P = 0.38）。