Zardi Enrico Maria, Pipita Maria Elena, Giorgi Chiara, Lichinchi Domenico, Zardi Domenico Maria, Afeltra Antonella
Hospitalist Service, "Campus Bio-Medico" University, Rome Radiology Department, S Maria della Misericordia Hospital, Urbino Division of Cardiology, Faculty of Medicine and Psychology, University of Rome "Sapienza," Sant'Andrea Hospital Immunorheumatology Unit, "Campus Bio-Medico" University, Rome, Italy.
Medicine (Baltimore). 2018 Jul;97(27):e11250. doi: 10.1097/MD.0000000000011250.
An increased vascular risk is present in patients with ankylosing spondylitis (AS). In this report, we evaluate the presence and grade of atherosclerosis in patients with AS, uninterruptedly treated with tumor necrosis factor-α (TNF-α) antagonists for 2 years, in comparison to that in a nontreated group of healthy controls.Fourteen patients with AS and 14 healthy controls underwent carotid sonography to measure intima-media thickness (IMT) and to evaluate the presence of plaque. Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index scores, erythrocyte sedimentation rate, C-reactive protein, glycemia, total cholesterol, and triglyceride levels were also recorded.Patients with AS showed significantly lower values of mean and maximum IMT at the level of the common carotid (P = .02 and .04, respectively) and the carotid bulb (P = .0006 and .0005, respectively) compared to those of healthy controls. They also had a number of carotid plaques significantly lower than that of healthy controls (P = .02). No differences were found in IMT values at the level of internal carotid between the 2 populations.The significantly lower carotid atherosclerosis found in patients with AS treated with TNF antagonists than in healthy controls shows the important complementary role of this treatment in reducing vascular disease progression probably by decreasing inflammation.
强直性脊柱炎（AS）患者存在血管风险增加的情况。在本报告中，我们评估了持续接受肿瘤坏死因子-α（TNF-α）拮抗剂治疗2年的AS患者与未治疗的健康对照组相比，动脉粥样硬化的存在情况和分级。14例AS患者和14例健康对照者接受了颈动脉超声检查，以测量内膜中层厚度（IMT）并评估斑块的存在情况。还记录了巴斯强直性脊柱炎疾病活动指数、巴斯强直性脊柱炎计量指数、巴斯强直性脊柱炎功能指数评分、红细胞沉降率、C反应蛋白、血糖、总胆固醇和甘油三酯水平。与健康对照者相比，AS患者在颈总动脉水平（分别为P = 0.02和0.04）和颈动脉球部水平（分别为P = 0.0006和0.0005）的平均IMT和最大IMT值显著更低。他们的颈动脉斑块数量也显著低于健康对照者（P = 0.02）。两组人群在内颈动脉水平的IMT值没有差异。接受TNF拮抗剂治疗的AS患者的颈动脉粥样硬化程度显著低于健康对照者，这表明该治疗可能通过减轻炎症在降低血管疾病进展方面具有重要的补充作用。
