类风湿关节炎血脂特征及其管理

Atherogenic Dyslipidemia and Its Management in Patients with Rheumatoid Arthritis

类风湿关节炎罹患心血管疾病并不少见。其心血管致残率及病死率较一般人群远远增加,部分原因归功于类风湿关节炎的血脂异常。类风湿关节炎的血脂异常非常复杂,与疾病的活动性及炎症密不可分。低水平的胆固醇浓度常是早期、活动性类风湿关节炎的表现;而药物常导致的类风湿关节炎患者胆固醇及三酰甘油水平升高。建议筛查类风湿关节炎患者的血脂及其他心血管疾病危险因素。尽管缺少大规模、高质量的前瞻性研究,控制血脂异常仍然是减少类风湿关节炎心血管并发症的有力措施。

Cardiovascular morbidity and mortality are enhanced in rheumatoid arthritis（RA）,which might be due to an increased prevalence of cardiovascular risk factors including dyslipidemia.Dyslipidemia in RA is very complex,and a higher disease activity is often associated with lower total cholesterol levels and even more depressed high-density lipoprotein levels,leading to a higher atherogenic index.Antirheumatic drug treatment with disease modifying antirheumatic drugs as well as TNF-blocking agents has,in general,favorable,albeit moderate,effects on the lipid profile.Hence,in addition to the assessment of the lipid profile,other cardiovascular risk factors should be determined and appropriate treatment installed when indicated.In addition,the management of dyslipidemia in RA should be part of a general cardiovascular risk management,although epidemiological data is still missing.