类风湿关节炎患者肱踝脉搏波传导速度及相关危险因素的研究

目的研究类风湿关节炎（rheumatoid arthritis，RA）患者动脉血管僵硬度的情况，探讨其与传统动脉硬化危险因素及疾病相关因素的关系。方法采用动脉硬化测定仪检测43例RA患者（RA组）及同期41名健康体检者（对照组）肱踝脉搏波传导速度（baPWV），了解动脉血管僵硬度，分析两组患者血压、血脂、血糖等传统心血管疾病危险因素的差异，并对RA疾病相关因素如病程、疾病活动指数（DAS28）、超敏C反应蛋白（hs-CRP）、类风湿因子（RF）及抗环瓜氨酸肽抗体（抗CCP）等与baPWV之间的关系进行研究。结果RA组患者baPWV显著高于健康对照组（P=0．000）；baPWV≥1400cm／s者RA组有24例（55．81％），健康对照组仅3例（7．3％），差异有统计学意义（P=0．0000）；RA患者中，baPWV〉1400cm／s者较baP．WV〈1400cm／s者年龄更大，有更长的病程，hs—CRP、血压及血脂水平均更高，但baPWV与RF及抗CCP无相关性。结论RA患者动脉血管僵硬度增高的发生率明显增高。除传统动脉硬化危险因素影响外．RA疾病相关的一些因素也参与其中。

Braclual-Ankle Pulse Wave Velocity and Associated Risk Factors in Patients with rheumatoid arthritis

To examine brachial-ankle Pulse Wave Velocity(baPWV)and associated risk factors in patients with rheumatoid arthritis(RA).Atherosclerosis tester was used to examine baPWV in 43 RA patients and 41 healthy controls without clinical cardiovascular disease.We evaluated the association between traditional cardiovascular risk factors including hypertension,lipid profile,obesity,age and baPWV.The relationship between the patient’s clinical characteristics and baPWV was examined.The levels of baPWV in RA patients were remarkably higher than those in healthy conthols(1573.20±386.15cm/s,1098.65±234.93cm/s,P=0.000).Twenty-four(55.81%)of RA patients had baPWV grater than 1400cm/s.However,baPWV grater than 1400cm/s was found in just 3 cases(7.3%)of healthy control(P=0.0000).Compared with RA patients with baPWV lower than 1400cm/s,RA patients with baPWV higher than 1400cm/s had Longer disease duration,higher level hs-CRP,hyperlipidemia.Neither RF nor anti-ccp antibody was correlated with baPWV.RA patients present higher prevalence of increased vascular stiffness than healthy controls.In addition to traditional risk factors for cardiovascular disease,disease related factors play important roles in progress of RA.