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血清阴性和血清阳性类风湿关节炎患者局部颈动脉僵硬度的评估

Assessment of local carotid stiffness in seronegative and seropositive rheumatoid arthritis.

作者信息

Aslan Abdullah Nabi, Şirin Özcan Ayşe Nur, Erten Şükran, Alsancak Yakup, Durmaz Tahir

机构信息

a Department of Cardiology , Atatürk Education and Research Hospital , Ankara , Turkey.

b Department of Radiology , Atatürk Education and Research Hospital , Ankara , Turkey.

出版信息

Scand Cardiovasc J. 2017 Oct;51(5):255-260. doi: 10.1080/14017431.2017.1343493. Epub 2017 Jun 23.

Abstract

OBJECTIVES

Rheumatoid arthritis (RA) is a chronic, inflammatory disease associated with increased risk of cardiovascular (CV) disease. Arterial stiffness (AS) is an independent predictor of CV events. This study aimed to analyse local carotid AS parameters in seronegative and seropositive RA patients.

DESIGN

Of 347 consecutive RA patients, we selected specifically those who were free of established CV diseases and risk factors. As a result, 140 patients (126 women, 52.2 ± 10 years) and 140 healthy controls (122 women, 52.7 ± 8.0 years) were enrolled into this study. The common carotid AS was evaluated using radio frequency echo-tracking system to determine the local carotid pulse wave velocity (cPWV) and carotid intima-media thickness (cIMT). Based on rheumatoid factor (RF) and/or anti-citrullinated protein antibody (ACPA) positivity, RA patients were categorized into seronegative and seropositive subgroups.

RESULTS

Carotid PWV was determined to be significantly higher in all patients and subgroups than controls (p < .001 for all). Although cIMT was similar between the patients, controls and seropositive subgroup, seronegative patients had significantly higher cIMT compared to controls (p = .035) and seropositive group (p = .010). Moreover, a significant positive correlation was found between cPWV and age (r: 0.603, p < .001), ESR (r: 0.297, p = .004), ACPA (r: 0.346, p = .001) and cIMT (r: 0.290, p = .005) in seropositive patients.

CONCLUSIONS

RA per se is sufficient to cause arteriosclerosis in the absence of classical CV risk factors. However, arterial hypertrophy is only increased in seronegative patients but not in seropositive group.

摘要

目的

类风湿关节炎(RA)是一种慢性炎症性疾病,与心血管(CV)疾病风险增加相关。动脉僵硬度(AS)是CV事件的独立预测因子。本研究旨在分析血清阴性和血清阳性RA患者的局部颈动脉AS参数。

设计

在347例连续的RA患者中,我们特别挑选了那些没有既定CV疾病和风险因素的患者。结果,140例患者(126名女性,52.2±10岁)和140名健康对照者(122名女性,52.7±8.0岁)被纳入本研究。使用射频回声跟踪系统评估颈总动脉AS,以确定局部颈动脉脉搏波速度(cPWV)和颈动脉内膜中层厚度(cIMT)。根据类风湿因子(RF)和/或抗瓜氨酸化蛋白抗体(ACPA)阳性,RA患者被分为血清阴性和血清阳性亚组。

结果

所有患者及其亚组的颈动脉PWV均显著高于对照组(所有p<0.001)。虽然患者、对照组和血清阳性亚组之间的cIMT相似,但血清阴性患者的cIMT显著高于对照组(p = 0.035)和血清阳性组(p = 0.010)。此外,血清阳性患者的cPWV与年龄(r:0.603,p<0.001)、红细胞沉降率(ESR,r:0.297,p = 0.004)、ACPA(r:0.346,p = 0.001)和cIMT(r:0.290,p = 0.005)之间存在显著正相关。

结论

在没有经典CV风险因素的情况下,RA本身足以导致动脉硬化。然而,动脉肥厚仅在血清阴性患者中增加,而在血清阳性组中未增加。

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