Department of Medical Imaging and Nuclear Medicine, Fourth Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang 150001, China.
Chin Med J (Engl). 2012 Mar;125(5):832-7.
Carotid artery intima-media thickness (CIMT) and brachial artery flow-mediated dilation percentage (FMD%) are common parameters used for detecting subclinical atherosclerosis. This study compared subclinical atherosclerosis of the carotid and brachial arteries in rheumatoid arthritis (RA) patients and healthy controls using high resolution ultrasonography. We also investigated their correlation with clinical factors and the association between FMD% and CIMT.
One hundred and two RA patients and 46 age-gender matched healthy controls were included in the study. FMD of the brachial artery and CIMT were measured ultrasonographically. Patients with diabetes mellitus, hypertension, renal failure, history of cardiovascular or cerebrovascular disease were excluded. Subjects who were receiving or used high dose steroids were also excluded.
The CIMT was significantly higher in patients than that in the control group ((0.697±0.053) vs. (0.554±0.051) mm, P<0.001), whereas brachial artery FMD% was lower in patients than that in the controls ((5.454±2.653)% vs. (8.477±2.851)%, P<0.001). CIMT was related to age, disease duration, tender and swollen joint score, C-reactive protein, systolic blood pressure and high-density lipoprotein. However, FMD% was only association with systolic blood pressure. There was no significant correlation between CIMT and FMD%.
Compared with the healthy control subjects, RA patients without clinically evident cardiovascular disease had subclinical atherosclerosis in terms of impaired FMD% and increased CIMT. FMD% and CIMT may measure a different stage of subclinical atherosclerosis in RA patients.
颈动脉内膜中层厚度（CIMT）和肱动脉血流介导的扩张百分比（FMD%）是用于检测亚临床动脉粥样硬化的常见参数。本研究使用高分辨率超声比较了类风湿关节炎（RA）患者和健康对照者的颈总动脉和肱动脉的亚临床动脉粥样硬化情况。我们还研究了它们与临床因素的相关性，以及 FMD%与 CIMT 之间的关联。
纳入 102 例 RA 患者和 46 名年龄性别匹配的健康对照者。超声测量肱动脉 FMD 和 CIMT。排除患有糖尿病、高血压、肾功能衰竭、心血管或脑血管疾病史的患者。排除正在接受或使用大剂量类固醇的患者。
与对照组相比，患者的 CIMT 明显升高（（0.697±0.053）vs.（0.554±0.051）mm，P<0.001），而患者的肱动脉 FMD%低于对照组（（5.454±2.653）%vs.（8.477±2.851）%，P<0.001）。CIMT 与年龄、病程、压痛和肿胀关节评分、C 反应蛋白、收缩压和高密度脂蛋白有关。然而，FMD%仅与收缩压有关。CIMT 与 FMD%之间无显著相关性。
与健康对照组相比，无明显临床心血管疾病的 RA 患者存在亚临床动脉粥样硬化，表现为 FMD%受损和 CIMT 增加。FMD%和 CIMT 可能在 RA 患者中测量不同阶段的亚临床动脉粥样硬化。
