Zhang Xingwen, Liu Ruozhuo, Wang Jing, Zhang Yuqi, Liu Yufei, Yu Zhe, Yu Shengyuan
Chinese PLA General Hospital, Beijing.
Acta Reumatol Port. 2016 Oct-Dec;41(4):322-327.
Patients with ankylosing spondylitis (AS) are at an elevated risk for the development of coronary artery disease, but the risk cerebrovascular disease among these patients remains incompletely understood. We investigated the cerebrovascular risk profiles of patients with a cerebrovascular disease and AS and compared these profiles to those of cerebrovascular disease patients without AS.
We retrospectively analyzed 34 patients with ischemic cerebrovascular disease also diagnosed with AS and 597 controls without AS with respect to patient age, gender, cerebrovascular risk factors, and laboratory test results.
AS patients were significantly younger than control patients in this study (56.2±13.5 years vs. 63.0±13.4 years, respectively; p=0.004). Logistic regression analysis did not indicate significant relationships between gender, cerebrovascular risk factors, and biochemical risk factors in AS patients, nor were any significant relationships found between erythrocyte sedimentation rate or C-reactive protein and biochemical risk factors. A low frequency of large-artery atherosclerosis and high frequency of small-vessel occlusion according to TOAST classification were found in AS patients with stroke.
Among the patients included in this study, patients with AS sought treatment for cerebrovascular disease were at a younger age compared to control patients without AS. Thus, our results indicate that AS patients have an increased risk for the premature onset of cerebrovascular disease. And the premature atherosclerosis may associate with the patients with AS. Furthermore, the high frequency of the small-vessel stroke subtype in AS patients indicates that small-vessel inflammation may be involved in the pathogenesis of vascular diseases in AS patients. Further prospective study with more samples will be needed to confirm this point of view.
强直性脊柱炎（AS）患者发生冠状动脉疾病的风险升高，但这些患者发生脑血管疾病的风险仍未完全明确。我们调查了患有脑血管疾病和AS的患者的脑血管风险概况，并将这些概况与无AS的脑血管疾病患者的概况进行比较。
我们回顾性分析了34例同时诊断为缺血性脑血管疾病和AS的患者以及597例无AS的对照者的年龄、性别、脑血管危险因素和实验室检查结果。
在本研究中，AS患者明显比对照患者年轻（分别为56.2±13.5岁和63.0±13.4岁；p = 0.004）。逻辑回归分析未表明AS患者的性别、脑血管危险因素和生化危险因素之间存在显著关系，红细胞沉降率或C反应蛋白与生化危险因素之间也未发现任何显著关系。根据TOAST分类，AS中风患者中大动脉粥样硬化的发生率低，小血管闭塞的发生率高。
在本研究纳入的患者中，因脑血管疾病寻求治疗的AS患者比无AS的对照患者年龄更小。因此，我们的结果表明AS患者发生脑血管疾病过早发作的风险增加。并且过早的动脉粥样硬化可能与AS患者有关。此外，AS患者中小血管中风亚型的高发生率表明小血管炎症可能参与了AS患者血管疾病的发病机制。需要更多样本的进一步前瞻性研究来证实这一观点。
