类风湿关节炎早期应用抗风湿药物在降低心血管事件发生率中的作用

Role of early application of anti-rheumatic drugs in reducing the incidence of cardiovascular events of rheumatoid arthritis

目的探讨类风湿关节炎早期应用抗风湿药物在降低心血管事件发生率中的作用。方法随机选取2010年6月至2013年6月收治的80例类风湿关节炎患者作为研究组,另选取同期体检的80例健康人员作为对照组。对照组无任何治疗,研究组患者给予泼尼松+甲氨喋呤+柳氮磺胺吡啶+硫酸羟氯喹抗风湿药物联合治疗。对两组人员的红细胞沉降率(ESR)、疾病活动分数(DAS28)、血脂[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]和炎症因子C-反应蛋白(CRP)变化情况以及动脉粥样硬化、心血管事件进行统计分析。结果治疗前研究组患者TC、TG、LDL-C、TC/HDL-C、LDL-C/HDL-C水平均显著高于对照组(P<0.05),HDL-C水平显著低于对照组(P<0.05);治疗后研究组的HDL-C水平显著高于治疗前(P<0.05),TC/HDL-C、LDL-C/HDL-C、DAS28、ESR、CRP水平均显著低于治疗前(P<0.05)。研究组动脉粥样硬化及心血管事件的发生率6.3%(5/80)、3.8%(3/80)均显著低于对照组15.0%(12/80)、10.0%(8/80)(P<0.05)。结论类风湿关节炎存在血脂异常升高,经抗风湿药物治疗后炎症因子、疾病活动分数得到有效降低,同时HDL-C水平升高,并能够有效降低动脉粥样硬化和心血管事件发生率。

Objective To investigate the role of early application of anti - rheumatic drugs in reducing the incidence of cardiovascular e-vents of rheumatoid arthritis. Methods 80 cases of rheumatoid arthritis patients who were treated in our hospital from June 2010 to June 2013 were randomly selected. These patients were regarded as the research group,and the other 80 cases of healthy people who took health examination in our hospital in the same period were selected as the control group. The patients in control group were not given any treatment,while the patients of study group were given methotrexate ＋ sulfasalazine ＋ hydroxychloroquine sulfate antirheumatic drug combination therapy. And then,the lip-ids and inflammatory factors changes of the two groups were statistically analyzed. Results The TC,TG,LDL - C,TC / HDL - C,LDL - C / HDL - C levels of of the study group were significantly higher（ P 〈 0. 05）. The HDL - C levels were significantly lower than those of the control group （ P 〈 0. 05）. The HDL - C levels after treatment was significantly higher（ P 〈 0. 05）. The TC / HDL - C,LDL - C / HDL - C,DAS28,ESR, CRP levels were significantly lower than before treatment（ P 〈 0. 05）. The incidence of atherosclerosis and cardiovascular events 6. 3%（5 / 80）, 3. 8%（3 / 80）were significantly lower than the control group 15. 0%（12 / 80）,10. 0%（8 / 80）（P 〈 0. 05）. Conclusion Rheumatoid arthritis increased presence of dyslipidemia,the anti - rheumatic drug therapy of inflammatory cytokines,disease activity score has been effectively re-duced,while increasing HDL - C levels,and can effectively reduce the incidence of atherosclerosis and cardiovascular events.