Gauri L A, Fatima Q, Diggi S, Khan A, Liyakat A, Nagar K
Senior Professor, Department of Medicine.
Professor, Department of Pathology.
J Assoc Physicians India. 2017 Jul;65(7):37-40.
RA is a chronic inflammatory state, predisposing for atherosclerosis as it is an immunoinflammatory process. This study focuses on use of Carotid artery intimomedial thickness (CIMT) as a marker for subclinical atherosclerosis.
To study the assessment of atherosclerosis by Carotid Intimo-Medial Thickness (CIMT) in patients with rheumatoid arthritis and Correlation of ultrasonographic findings with severity of disease (using DAS-28 score).
A prospective, case-control study involving 50 cases of diagnosed RA cases, and 50 healthy control. Sonological examination of the carotid and the vertebral arteries was done using a L&T SEQUINA color Doppler scanner with a linear band probe of frequency 6.6 to 14 MHz's.
This case control study was carried out in 100 subjects (50 cases and 50 controls). Cases comprised of 41 rheumatic women (Mean age 42.08+12.13 yrs) and 9 (mean age 48.4+12.8 years) rheumatic men. Mean CIMT of the study group (0.5996+0.109mm) was significantly greater (p<0.001) than that of control group (0.5290+0.006mm). We observed carotid plaques in 18% subjects of study group compared to 2% in controls (p<0.001). Mean age in the study group was 46.56+12.82 years and that of controls was 46.38+11.69 years (p>0.05). In the study group mean CIMT was significantly increased in RA factor positive patients than in RA factor negative patients. We also calculated the DAS-28 score of the study group subjects and found that 8, 27 and 15 were having Mild, Moderate & severe disease activity respectively.
CIMT has significant correlation with the age, and CIMT increases with age. Mean CIMT was found to be more with RF+(ve) patients indicating acute inflammation also has a role. When compared, the mean CIMT in each DAS sub group the result was found to be statistically insignificant.
类风湿关节炎（RA）是一种慢性炎症状态，由于其是一种免疫炎症过程，易引发动脉粥样硬化。本研究聚焦于使用颈动脉内膜中层厚度（CIMT）作为亚临床动脉粥样硬化的标志物。
研究通过颈动脉内膜中层厚度（CIMT）评估类风湿关节炎患者的动脉粥样硬化情况，以及超声检查结果与疾病严重程度（使用DAS-28评分）的相关性。
一项前瞻性病例对照研究，纳入50例确诊的RA患者和50例健康对照。使用L&T SEQUINA彩色多普勒扫描仪及频率为6.6至14MHz的线性带探头对颈动脉和椎动脉进行超声检查。
本病例对照研究共纳入100名受试者（50例患者和50例对照）。病例组包括41名风湿性女性（平均年龄42.08±12.13岁）和9名风湿性男性（平均年龄48.4±12.8岁）。研究组的平均CIMT（0.5996±0.109mm）显著高于对照组（0.5290±0.006mm）（p<0.001）。研究组18%的受试者发现有颈动脉斑块，而对照组为2%（p<0.001）。研究组的平均年龄为46.56±12.82岁，对照组为46.38±11.69岁（p>0.05）。在研究组中，类风湿因子阳性患者的平均CIMT显著高于类风湿因子阴性患者。我们还计算了研究组受试者的DAS-28评分，发现8例、27例和15例分别具有轻度、中度和重度疾病活动。
CIMT与年龄有显著相关性，且CIMT随年龄增加而升高。发现类风湿因子阳性（RF+(ve)）患者的平均CIMT更高，表明急性炎症也起作用。比较各DAS亚组的平均CIMT时，结果无统计学意义。
