早期类风湿关节炎中无症状性动脉高血压的患病率及其与炎症活动的相关性
Prevalence of Asymptomatic Arterial Hypertension and Its Correlation with Inflammatory Activity in Early Rheumatoid Arthritis.
作者信息
Bajraktari Ismet H, Rexhepi Sylejman, Berisha Idriz, Lahu Ali, Kryeziu Avni, Durmishi Bastri, Bajraktari Halit, Bahtiri Elton
机构信息
Clinic of Rheumatology, University Clinical Center of Kosovo, Prishtina, Kosovo.
Emergency Center, University Clinical Center of Kosovo, Prishtina, Kosovo.
出版信息
Open Access Maced J Med Sci. 2017 Aug 10;5(5):641-644. doi: 10.3889/oamjms.2017.146. eCollection 2017 Aug 15.
BACKGROUND
Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that worsens during the course of the disease and can cause disability. Early RA refers to the onset of symptoms within the past 3 months. In RA, increased levels of mediators of inflammation may cause arterial stiffness consequently leading to arterial hypertension.
AIM
The aim of this cross-sectional study was to assess the prevalence of asymptomatic arterial hypertension in early RA patients as well as the correlation with parameters of inflammation.
METHODS
One hundred and seventy-nine early RA patients diagnosed in agreement with ACR/EULAR (American College of Rheumatology/ European League against Rheumatism) 2010 criteria were consecutively included in the study. CRP (C-reactive protein) and anti CCP (Antibodies to cyclic citrullinated peptides) serum levels, WBC (white blood cells) count and ESR (Erythrocyte sedimentation rate), likewise DAS-28 (28-joint disease activity score) were determined in all included patients. Parametric tests were used to compare the characteristics of the groups and to test the correlation of the variables.
RESULTS
Statistical data analysis revealed that a majority of the patients were females (n = 141; 78.7%); the mean age at RA onset was 49.13 ± 12.13 years. Overall prevalence of hypertension was 44.13 % (n = 79). In comparison with the normotensive patients, the hypertensive patients were older and had significantly higher values of CRP, ESR, anti-CCP and DAS-28. A highly significant positive correlation between all the study parameters and systolic and diastolic blood pressure was observed.
CONCLUSION
Presence of significantly higher values of CRP, ESR, anti-CCP and DAS-28 in hypertensive patients indicate that inflammation is associated with an increased risk of hypertension. In this context, early screening for arterial hypertension and adequate therapeutic measures should be considered in early RA patients.
背景
类风湿关节炎（RA）是一种慢性全身性炎症性疾病，在疾病过程中会恶化并可能导致残疾。早期RA是指在过去3个月内出现症状。在RA中，炎症介质水平升高可能导致动脉僵硬，进而导致动脉高血压。
目的
本横断面研究的目的是评估早期RA患者无症状动脉高血压的患病率以及与炎症参数的相关性。
方法
连续纳入179例符合美国风湿病学会/欧洲抗风湿病联盟（ACR/EULAR）2010标准诊断的早期RA患者。测定所有纳入患者的血清C反应蛋白（CRP）、抗环瓜氨酸肽抗体（抗CCP）水平、白细胞（WBC）计数、红细胞沉降率（ESR）以及28关节疾病活动评分（DAS-28）。采用参数检验比较各组特征并检验变量间的相关性。
结果
统计数据分析显示，大多数患者为女性（n = 141；78.7%）；RA发病时的平均年龄为49.13±12.13岁。高血压的总体患病率为44.13%（n = 79）。与血压正常的患者相比，高血压患者年龄更大，CRP、ESR、抗CCP和DAS-28值显著更高。观察到所有研究参数与收缩压和舒张压之间存在高度显著的正相关。
结论
高血压患者中CRP、ESR、抗CCP和DAS-28值显著更高，表明炎症与高血压风险增加有关。在此背景下，应考虑对早期RA患者进行动脉高血压的早期筛查和适当的治疗措施。
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