Kimhi Oded, Caspi Dan, Bornstein Natan M, Maharshak Nitsan, Gur Alexander, Arbel Yaron, Comaneshter Doron, Paran Daphna, Wigler Irena, Levartovsky David, Berliner Shlomo, Elkayam Ori
Department of Rheumatology, Tel Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Semin Arthritis Rheum. 2007 Feb;36(4):203-9. doi: 10.1016/j.semarthrit.2006.09.001. Epub 2006 Oct 25.
To evaluate the extent of subclinical atherosclerosis by measuring the intima-media wall thickness (IMT) of the common carotid artery in patients with psoriatic arthritis (PsA) and to identify vascular risk factors associated with PsA.
Forty-seven patients with PsA were compared with 100 allegedly healthy subjects. Carotid duplex scanning was used to measure common carotid artery IMT. Traditional risk factors, such as gender, age, body mass index (BMI), hypertension, smoking, and lipids were checked. Assessment of PsA activity included clinical patterns of involvement, degree of severity, duration of morning stiffness, number of tender and swollen joints, degree of pain and fatigue, the Bath Ankylosing Spondylitis Disease Activity Index, the Psoriasis Area and Severity Index, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and fibrinogen.
The average IMT (mean +/- standard deviation) for PsA patients was significantly higher compared with controls (0.76 +/- 0.11 versus 0.64 +/- 0.27, respectively, P < 0.00001) for the whole group and after adjustment for age, gender, BMI, hypertension, and hyperlipidemia. The PsA subjects had significantly higher levels of hypertension, hyperlipidemia, ESR, CRP, and fibrinogen, and their average IMT significantly correlated with age, BMI, duration of skin and joint disease, spine involvement, ESR, and fibrinogen. IMT did not correlate with the presence of oligo- or polyarthritis but was increased in patients with clinical spinal involvement. IMT was not associated with the degree of severity or the use of different therapies for PsA, including methotrexate or tumor necrosis factor-alpha-blocking agents.
PsA patients exhibited greater IMT than healthy controls. Increased IMT independently correlated with parameters of disease activity and conventional risk factors of atherosclerosis.
通过测量银屑病关节炎（PsA）患者颈总动脉的内膜中层厚度（IMT）来评估亚临床动脉粥样硬化的程度，并确定与PsA相关的血管危险因素。
将47例PsA患者与100名据称健康的受试者进行比较。采用颈动脉双功超声扫描测量颈总动脉IMT。检查传统危险因素，如性别、年龄、体重指数（BMI）、高血压、吸烟和血脂。PsA活动度评估包括受累的临床模式、严重程度、晨僵持续时间、压痛和肿胀关节数量、疼痛和疲劳程度、巴斯强直性脊柱炎疾病活动指数、银屑病面积和严重程度指数、红细胞沉降率（ESR）、C反应蛋白（CRP）和纤维蛋白原。
PsA患者的平均IMT（均值±标准差）在全组以及在调整年龄、性别、BMI、高血压和高脂血症后，均显著高于对照组（分别为0.76±0.11与0.64±0.27，P<0.00001）。PsA受试者的高血压、高脂血症、ESR、CRP和纤维蛋白原水平显著更高，且其平均IMT与年龄、BMI、皮肤和关节疾病持续时间、脊柱受累、ESR和纤维蛋白原显著相关。IMT与少关节炎或多关节炎的存在无关，但在有临床脊柱受累的患者中增加。IMT与PsA的严重程度或不同治疗方法的使用无关，包括甲氨蝶呤或肿瘤坏死因子-α阻断剂。
PsA患者的IMT高于健康对照组。IMT增加与疾病活动参数和动脉粥样硬化的传统危险因素独立相关。
