Gonzalez-Juanatey Carlos, Llorca Javier, Miranda-Filloy Jose A, Amigo-Diaz Encarnacion, Testa Ana, Garcia-Porrua Carlos, Martin Javier, Gonzalez-Gay Miguel A
Hospital Xeral-Calde, Lugo, Spain.
Arthritis Rheum. 2007 Mar 15;57(2):287-93. doi: 10.1002/art.22530.
To determine whether endothelial dysfunction was present in a cohort of patients with psoriatic arthritis (PsA) without overt cardiovascular disease or classic cardiovascular risk factors attended to in a community hospital.
Fifty patients with PsA who fulfilled the Moll and Wright criteria were recruited from Hospital Xeral-Calde (Lugo, Spain). Patients seen during the period of recruitment who had classic cardiovascular risk factors or had experienced cardiovascular or cerebrovascular events were excluded. Fifty healthy matched controls were also studied. In all patients and controls, endothelial function was determined by measuring flow-mediated endothelial dependent vasodilatation (FMD%) and endothelial independent vasodilatation (GTN%) by brachial ultrasonography.
FMD% was significantly impaired in patients compared with controls (mean, median [range] 6.3%, 6.1% [0.3-13.4%] versus 8.2%, 8.2% [0.0-21.2%]; P = 0.008). However, no significant difference existed between patients and controls in GTN% or baseline diameter. A significant correlation between C-reactive protein level and erythrocyte sedimentation rate at the time of disease diagnosis and FMD% was found (P < 0.04). No significant FMD% and GTN% differences were observed when patients with PsA with polyarticular pattern were compared with the remaining patients with PsA.
The present study demonstrates that patients with PsA without cardiovascular risk factors or clinically evident cardiovascular disease also exhibit endothelial dysfunction. These observations provide a basis for the potential association between PsA and atherosclerotic disease.
确定在一家社区医院就诊的一组无明显心血管疾病或经典心血管危险因素的银屑病关节炎（PsA）患者中是否存在内皮功能障碍。
从西班牙卢戈市的塞拉尔 - 卡尔德医院招募了50名符合莫尔和赖特标准的PsA患者。排除在招募期间发现有经典心血管危险因素或有心血管或脑血管事件的患者。还研究了50名健康匹配对照。对所有患者和对照，通过肱动脉超声测量血流介导的内皮依赖性血管舒张（FMD%）和内皮非依赖性血管舒张（GTN%）来确定内皮功能。
与对照组相比，患者的FMD%显著受损（均值、中位数[范围]6.3%，6.1%[0.3 - 13.4%]对8.2%，8.2%[0.0 - 21.2%]；P = 0.008）。然而，患者和对照在GTN%或基线直径方面无显著差异。发现疾病诊断时的C反应蛋白水平和红细胞沉降率与FMD%之间存在显著相关性（P < 0.04）。将多关节型PsA患者与其余PsA患者比较时，未观察到FMD%和GTN%有显著差异。
本研究表明，无心血管危险因素或临床明显心血管疾病的PsA患者也存在内皮功能障碍。这些观察结果为PsA与动脉粥样硬化疾病之间的潜在关联提供了依据。
