类风湿关节炎患者心血管病变的发生机制与治疗措施

The mechanism and treatment measures of cardiovascular disease in rheumatoid arthritis patients

目的探讨类风湿关节炎患者心血管病变的发生机制与治疗措施。方法选择类风湿关节炎合并心血管疾病患者(观察组)60例和单纯类风湿关节炎患者(对照组)60例,均采用甲氨喋呤结合来氟米特治疗。两组治疗前后都检测血沉(ESR)、C反应蛋白(CRP)、类风湿因子(RF)及血液流变学指标的变化。结果经过观察,观察组治疗前的ESR、CRP、全血高切还原黏度、全血低切还原黏度、红细胞压积水平明显高于对照组,RF水平明显低于对照组(P<0.05);观察组治疗后有明显改善,组间对比差异无统计学意义(P>0.05)。结论类风湿关节炎患者多伴随有心血管疾病,其发病可能与炎症因子、血液流变学指标变化有直接关系,药物联合治疗后可促进患者的转归。

Objective To explore the mechanism and therapeutic measures of cardiovascular disease in rheumatoid arthmtis patients. Methods 60 cases of rheumatoid arthritis patients combined with cardiovascular disease were selected as the ob- servation group and 60 cases of rheumatoid arthritis patients were selected as the the control group. All patients were treated with the Methotrexate combined with Sulfasalazine. Erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP）, rheumatoid factor （RF） and hemorheology index were detected among all cases before and after treatment. Results The ESR, CRP, whole blood high viscosity reduction, whole blood low viscosity reduction, hematokrit levels before treatment of the observation group were all significantly higher than those of the control group, and the RF level was significantly lower than the control group （P 〈 0.05） before treatment. After treatment all index improved in the observation group, there were no significant differences between the two groups （P 〉 0.05）. Conclusion Most rheumatoid arthritis patients accompanies with cardiovascular disease, its incidence may relate to the inflammation factors and hemorheology changes, combination therapy can promote the outcome of patients.