Mahajan V, Handa R, Kumar U, Sharma S, Gulati G, Pandey R M, Lakshmy R
Department of Medicine, All India Institute of Medical Sciences, New Delhi.
J Assoc Physicians India. 2008 Aug;56:587-90.
To determine the prevalence of subclinical (asymptomatic) atherosclerosis in patients with rheumatoid arthritis (RA) and to study the variables affecting such an occurrence.
Case control study which included 100 patients with RA having disease duration more than 5 years and 100 healthy age and sex matched controls. Cases and controls symptomatic for atherosclerosis or having traditional risk factors for atherosclerosis were excluded. Both cases and controls were subjected to carotid ultrasound examination in addition to detailed history and physical examination.
The study population (both cases and controls) included 94 females and 6 males. The mean age of cases and controls was similar (44.06 +/- 11.32 years and 44.1 +/- 11.52 years). The mean disease duration was 155.04 +/- 48.8 months. The mean carotid intimo-medial thickness (CIMT) of the RA patients (0.519 +/- 0.18 mm) was significantly greater than the controls (0.387 +/- 0.085). Age and disease duration were the only factors found to significantly affect CCIMT. RA patients had higher prevalence of carotid plaques (21%) compared to controls (1%). Erosions on hand radiographs were the only significant predictor of plaques in patients with RA.
Patients with RA exhibit premature atherosclerosis by way of increased CIMT and carotid plaques when compared to age and sex matched controls.
确定类风湿关节炎（RA）患者亚临床（无症状）动脉粥样硬化的患病率，并研究影响其发生的变量。
病例对照研究，纳入100例病程超过5年的RA患者以及100例年龄和性别匹配的健康对照。排除有动脉粥样硬化症状或具有动脉粥样硬化传统危险因素的病例和对照。除详细的病史和体格检查外，病例和对照均接受颈动脉超声检查。
研究人群（病例和对照）包括94名女性和6名男性。病例组和对照组的平均年龄相似（分别为44.06±11.32岁和44.1±11.52岁）。平均病程为155.04±48.8个月。RA患者的平均颈动脉内膜中层厚度（CIMT）（0.519±0.18mm）显著大于对照组（0.387±0.085）。年龄和病程是仅有的被发现显著影响CIMT的因素。与对照组（1%）相比，RA患者颈动脉斑块的患病率更高（21%）。手部X线片上的侵蚀是RA患者斑块的唯一显著预测因素。
与年龄和性别匹配的对照组相比，RA患者通过增加CIMT和颈动脉斑块表现出过早的动脉粥样硬化。
