Pahor A, Hojs R, Gorenjak M, Rozman B
Department of Rheumatology, Clinical Department of Internal Medicine, University Hospital Maribor, Ljubljanska 5, 2000 Maribor, Slovenia.
Rheumatol Int. 2006 Dec;27(2):119-23. doi: 10.1007/s00296-006-0176-6. Epub 2006 Sep 5.
Increased mortality due to cardiovascular disease in rheumatoid arthritis (RA) patients was reported. Using B-mode ultrasonography we compared intima-media thickness (IMT) and plaque occurrence (indicators of asymptomatic atherosclerosis) in the carotid arteries in 70 pre-menopausal, female RA patients and 40 controls. Correlations with different risk factors were evaluated. The IMT values were higher in RA patients (0.59 mm vs. 0.47 mm, P < 0.0001) and they had more plaques (P = 0.023). In RA patients higher levels of sensitive CRP (P < 0.0001), ICAM (P < 0.0001), VCAM (P < 0.0001), IL-2 (P < 0.001), IL-6 (P = 0.009) and TNF-alfa (P < 0.01) were found. A correlation between IMT and triglycerides (P = 0.018) and a negative correlation between IMT and HDL cholesterol (P = 0.037) were found. With multiple regression analysis the association between IMT and sensitive CRP (P = 0.027) and presence of plaques and apolipoprotein B (P = 0.028) was established. The results indicate that even pre-menopausal, female RA patients had accelerated atherosclerosis. Chronic systemic inflammation may play an important role in atherogenesis.
据报道，类风湿关节炎（RA）患者因心血管疾病导致的死亡率增加。我们使用B型超声检查比较了70名绝经前女性RA患者和40名对照者颈动脉的内膜中层厚度（IMT）和斑块发生率（无症状动脉粥样硬化的指标）。评估了与不同风险因素的相关性。RA患者的IMT值更高（0.59毫米对0.47毫米，P<0.0001），且斑块更多（P = 0.023）。在RA患者中，发现敏感CRP（P<0.0001）、ICAM（P<0.0001）、VCAM（P<0.0001）、IL-2（P<0.001）、IL-6（P = 0.009）和TNF-α（P<0.01）水平更高。发现IMT与甘油三酯之间存在相关性（P = 0.018），IMT与高密度脂蛋白胆固醇之间存在负相关性（P = 0.037）。通过多元回归分析，确定了IMT与敏感CRP之间的关联（P = 0.027）以及斑块与载脂蛋白B之间的关联（P = 0.028）。结果表明，即使是绝经前女性RA患者也存在动脉粥样硬化加速的情况。慢性全身炎症可能在动脉粥样硬化形成中起重要作用。
