Framingham评分预测关节型银屑病患者心血管疾病风险及危险因素分析

目的应用Framingham评分预测关节型银屑病(PsA)患者未来10年心血管疾病的患病风险,并明确PsA患者未来10年发生心血管疾病的相关危险因素。方法选取2014年1月至2018年12月该院皮肤科收治的PsA患者112例作为观察组;选取同期体检健康人群(性别、年龄等相匹配)68例作为对照组。比较2组一般资料和总胆固醇(TC)、三酰甘油(TG)、血尿酸(UA)等生化指标;应用Framingham评分预测PsA患者未来10年发生心血管疾病的患病风险,Pearson相关分析、Logistic回归分析评估PsA患者发生心血管疾病的相关因素和危险因素。结果观察组男性多于女性(男∶女=1.29∶1);初发关节炎发病年龄为(48.18±13.24)岁;患者皮损中位病程和关节炎中位病程分别为13.1(11.6,14.6)年和4.5(3.0,6.0)年;观察组患者收缩压、吸烟史、既往史、TG、UA明显高于对照组(P<0.05),高密度脂蛋白胆固醇(HDL-C)明显低于对照组(P<0.05);TC、低密度脂蛋白胆固醇(LDL-C)、临床用药2组之间差异无统计学意义(P>0.05)。观察组和对照组患者Framingham评分结果分别为18.0(16.0,20.0)分、6.0(4.0,7.0)分,且Mann-Whitney检验证实2组之间差异有统计学意义(P<0.05)。10年Framingham评分与性别、年龄、初发年龄、TG、UA相关(P<0.05),且年龄、既往史、TG、UA是PsA患者发生心血管事件的独立危险因素(P<0.05)。结论PsA患者心血管疾病患病风险高,关注患者年龄、是否伴有高血压和糖尿病及定期监测TG、UA可有效评估患者发生心血管疾病的患病风险。

Framingham score predicts cardiovascular risk and its risk factors in patients with psoriatic arthritis

Objective Framingham score was used to evaluate and predict the risk of cardiovascular disease in patients with psoriatic arthritis(PsA)in the next 10 years,and to identify the risk factors of cardiovascular disease in patients with PsA in the next 10 years.Methods From January 2014 to December 2018,112 patients with PsA admitted to the dermatology department of the hospital were selected as the observation group,and 68 healthy people(matched by gender and age)were selected as the control group.The general data,TC,TG,UA and other biochemical indexes were compared between the two groups.Framingham score was used to evaluate and predict the risk of cardiovascular disease in PsA patients in the next 10 years.Spearman correlation analysis and Logistic regression analysis were used to evaluate the correlation of cardiovascular disease in PsA patients and risk factors.Results There were more males than females in the observation group(male to female=1.29∶1);the onset age of primary arthritis was(48.18±13.24)years;the median course of lesions and arthritis was 13.1(11.6,14.6)years and 4.5(3.0,6.0)years,respectively.The systolic blood pressure,smoking history,past history,TG and UA in the observation group were significantly higher than those in the control group(P<0.05),and HDL-C was significantly lower than those in the control group(P<0.05);there was no significant difference in TC,LDL-C and clinical medication between the two groups(P>0.05).The Framingham scores of the patients in the observation group and the control group were 18.0(16.0,20.0)and 6.0(4.0,7.0),respectively,and the difference between the two groups was statistically significant(P<0.05).The scores of Framingham in 10 years were correlated with sex,age,initial age,TG,UA(P<0.05),and age,past history,TG,UA were independent risk factors for cardiovascular events in patients with PsA(P<0.05).Conclusion Patients with PsA have a high risk of cardiovascular disease.Paying attention to age,hypertension and diabetes,and monitoring TG and UA regularly can effectively assess the risk of cardiovascular disease.