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探讨不同治疗方式对强直性脊柱炎患者血管壁结构和功能的影响。

Investigation of effects of different treatment modalities on structural and functional vessel wall properties in patients with ankylosing spondylitis.

机构信息

Karadeniz Technical University, Medical School, Dept. of Physical Medicine and Rehabilitation, Farabi Hospital, 61080 Trabzon, Turkey.

出版信息

Joint Bone Spine. 2011 Jul;78(4):378-82. doi: 10.1016/j.jbspin.2010.09.023. Epub 2010 Dec 9.

Abstract

AIM

Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that is associated with increased cardiovascular burden. The aim of this study was to investigate vascular structural and functional changes in patients with AS, with special emphasis on the effects of different treatment modalities, through evaluation of level of vascular stiffness (pulse wave velocity [PVW]) and carotid intima media thickness (IMT-C).

METHODS

A total of 67 AS patients, and age, sex, body mass index (BMI) smoking status, lipid profiles and blood pressure-matched healthy control subjects (n=34) were studied. Of these, 34 patients were on anti-TNF alpha and 33 on non steroid anti inflammatory drugs (NSAIDs). The IMT-C and PWV values of the right common carotid artery were measured by high-resolution ultrasound.

RESULTS

The AS patients (n=67) had significantly higher PWV values than the controls [9.0 ± 1.49 m/sec vs. 8.27 ± 0.90 m/sec, P=0.004; 95% confidence interval (CI), -1.22 to -0.24]. Multiple stepwise linear regression analysis revealed that PWV could only be explained by systolic blood pressure (P<0.05) and IMT (P<0.05) in AS. Even though IMT-C in anti-TNF alpha treated group was higher compared to the NSAID treated group, it was not statistically significant (P=0.5).

CONCLUSION

PWV was found to be higher in AS patients than in the control group, and there was no significant difference between the average PWV values of AS patients treated with anti -TNF alpha or NSAIDs.

摘要

目的

强直性脊柱炎(AS)是一种慢性系统性炎症性疾病,与心血管负担增加有关。本研究旨在通过评估血管硬度(脉搏波速度[PW V])和颈动脉内膜中层厚度(IMT-C),研究 AS 患者的血管结构和功能变化,并特别关注不同治疗方式的影响。

方法

共纳入 67 例 AS 患者和 34 名年龄、性别、体重指数(BMI)、吸烟状况、血脂谱和血压匹配的健康对照组。其中,34 例患者接受抗 TNF-α治疗,33 例患者接受非甾体抗炎药(NSAIDs)治疗。通过高分辨率超声测量右侧颈总动脉的 IMT-C 和 PW V 值。

结果

AS 患者(n=67)的 PW V 值明显高于对照组[9.0±1.49 m/sec 比 8.27±0.90 m/sec,P=0.004;95%置信区间(CI),-1.22 至-0.24]。多元逐步线性回归分析显示,PW V 仅能由 AS 患者的收缩压(P<0.05)和 IMT(P<0.05)解释。尽管与 NSAIDs 治疗组相比,抗 TNF-α治疗组的 IMT-C 更高,但差异无统计学意义(P=0.5)。

结论

与对照组相比,AS 患者的 PW V 值更高,接受抗-TNFα或 NSAIDs 治疗的 AS 患者的平均 PW V 值无显著差异。

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