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[银屑病关节炎和类风湿关节炎中的心血管危险因素]

[Cardiovascular risk factors in psoriatic and rheumatoid arthritis].

作者信息

Rebrov A P, Nikitina N M, Gaĭdukova I Z

出版信息

Ter Arkh. 2011;83(5):20-4.

Abstract

AIM

To study the role of conventional and new factors of cardiovascular risk in development of atherosclerosis in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PA).

MATERIAL AND METHODS

Sixty patients with psoriatic arthritis, 414 RA patients and 79 healthy controls entered the trial. All of them had no manifestations of cardiovascular diseases. Screening was made of the leading risk factors of cardiovascular diseases and cardiovascular complications, thickness of the complex intima-media (TIM) of the carotid arteries, vascular wall stiffness were measured, vasoregulatory function of the endothelium, markers of endothelial damage were examined.

RESULTS

Patients with psoriatic and rheumatoid arthritis were found to have increased TIM of the carotid arteries, high incidence of atherosclerotic plaques, increased stiffness, damage of the vascular wall, affected endothelial vasoregulation. These alterations were associated with high arthritis activity, systemic manifestations, seropositivity by rheumatoid factor (in RA), presence of entesitis, uveitis and dactilitis (in psoriatic arthritis), dislipidemia, arterial hypertension (AH).

CONCLUSION

To determine cardiovascular risk in patients with arthritis, it is necessary to consider not only standard risk factors (dislipidemia and AH), but also severity of systemic inflammation, arterial stiffness, endothelial damage and ability of the vascular wall to relax reflecting endothelial dysfunction.

摘要

目的

研究传统及新型心血管危险因素在类风湿关节炎(RA)和银屑病关节炎(PA)患者动脉粥样硬化发展中的作用。

材料与方法

60例银屑病关节炎患者、414例RA患者及79名健康对照者纳入试验。所有受试者均无心血管疾病表现。对心血管疾病及心血管并发症的主要危险因素进行筛查,测量颈动脉内膜中层复合体(TIM)厚度、血管壁僵硬度,检测内皮血管调节功能、内皮损伤标志物。

结果

银屑病关节炎和类风湿关节炎患者颈动脉TIM增厚、动脉粥样硬化斑块发生率高、僵硬度增加、血管壁受损、内皮血管调节功能受影响。这些改变与关节炎活动度高、全身表现、类风湿因子血清阳性(RA患者)、存在肠炎、葡萄膜炎和指(趾)炎(银屑病关节炎患者)、血脂异常、动脉高血压(AH)有关。

结论

为确定关节炎患者的心血管风险,不仅要考虑标准危险因素(血脂异常和AH),还应考虑全身炎症的严重程度、动脉僵硬度、内皮损伤以及反映内皮功能障碍的血管壁舒张能力。

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