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类风湿性关节炎:一种心血管疾病?

[Rheumatoid arthritis: a cardiovascular disease?].

作者信息

Daïen C I, Fesler P

机构信息

Service d'immuno-rhumatologie, CHU Lapeyronie, Montpellier, France.

出版信息

Ann Cardiol Angeiol (Paris). 2012 Apr;61(2):111-7. doi: 10.1016/j.ancard.2011.07.008. Epub 2011 Aug 17.

Abstract

Mortality in rheumatoid arthritis (RA) is doubled when compared to the general population. This excess in mortality can be explained in half of cases by cardiovascular (CV) events. The risk of myocardial infarction is increased by about 60% in RA. Mortality secondary to cerebrovascular stroke is increased by 50% even if the incidence of stroke is not increased. Indeed, the risk of fatal CV events is increased in RA when compared to the general population. The increased CV risk cannot be explained only by traditional CV risk factors, even if smoking and changes in lipid profile may be implied. It is mainly related to the chronic inflammatory condition that causes many metabolic disturbances. Other parameters such as treatments used in RA also play a role. Thus, it is essential for proper management of RA patients to be aware of this risk and to treat any modifiable CV risk factors.

摘要

与普通人群相比,类风湿关节炎(RA)患者的死亡率翻倍。这种死亡率过高的情况在一半的病例中可归因于心血管(CV)事件。RA患者发生心肌梗死的风险增加约60%。即使中风的发病率没有增加,因脑血管中风导致的死亡率也会增加50%。事实上,与普通人群相比,RA患者发生致命CV事件的风险更高。CV风险增加不能仅用传统的CV风险因素来解释,即使吸烟和血脂谱变化可能与之有关。这主要与导致许多代谢紊乱的慢性炎症状态有关。RA中使用的其他参数如治疗方法也起作用。因此,对于RA患者的恰当管理,了解这种风险并治疗任何可改变的CV风险因素至关重要。

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