类风湿关节炎患者心血管疾病危险因素调查

Cardiovascular risk factors in patients with rheumatoid arthritis

目的 了解类风湿关节炎患者心血管疾病的危险因素发生情况,为实施心血管疾病干预措施提供依据.方法 纳入2013年1月至2014年1月类风湿关节炎患者240例,进行心血管疾病危险因素调查,包括年龄、病程、体重指数、既往史、空腹血糖、血尿酸、血脂、C反应蛋白、红细胞沉降率、类风湿因子、抗瓜氨酸肽抗体、吸烟等,比较不同性别、年龄患者间上述指标的差异,并对35 ～ 59岁人群用“国人缺血性心血管病（ICVD） 10年发病危险度评估表”进行危险度评估.结果 男性类风湿关节炎患者的年龄、吸烟比例和血尿酸水平均高于女性,差异有统计学意义[（55±10）岁比（51±10）岁、87.1％（54/62）比12.4％（22/178）、（276±79） μmol/L比（234±66） μmol/L,P＜0.05].类风湿关节炎患者高血压、糖尿病、高总胆固醇血症、高三酰甘油血症、低高密度脂蛋白胆固醇血症、高低密度脂蛋白胆固醇血症、高尿酸血症发生率分别为26.7％（64/240）、11.7％（28/240）、35.4％ （85/240）、25.4％（61/240）、13.3％（32/240）、4.2％ （10/240）、4.6％ （11/240）;总吸烟率为31.7％ （76/240）,超重率为59.2％（142/240）.42.5％（102/240）患者有≥3个危险因素,其中男性该比例高于女性该比例[54.8％（34/62）比38.2％（68/178）,P＜0.05],各年龄段危险因素的聚集分布情况差异无统计学意义（P＞0.05）.类风湿关节炎患者10年ICVD发病危险度处于中危及以上的检出率为6.9％（11/160）;除55 ～ 59岁年龄段男性患者外,其余患者ICVD危险度均高于各年龄段绝对平均危险度参考标准.结论 类风湿关节炎患者心血管疾病危险因素水平较高,35～ 59岁人群10年ICVD发病风险较大.

Objective To investigate the cardiovascular risk factors in patients with rheumatoid arthritis （RA）.Methods Totally 240 patients with RA from January 2013 to January 2014 were enrolled.The cardiovas-cularrisk factors,including age,course of disease,body mass index,past history,fasting blood glucose,blood uric acid,blood lipid,C-reactive protein,erythrocyte sedimentation rate （ESR）,rheumatoid factor,anti-cyclic cirullinated peptide antibody,smoking were investigated and compared.The risks of patients from 35 to 59 years old were evaluated by ＆quot; National 10-year Risk Assessment for ischemic cardiovascular disease （ICVD）＆quot;.Results The age,proportion of smoker and level of serum uric acid in male patients were significantly higher than those in female patients [（55 ± 10） years vs （51 ± 10） years,87.1% （54/62） vs 12.4% （22/178）,（276 ± 79） μmol/L vs （234 ± 66） μmol/L] （P 〈 0.05）.The prevalence of hypertension,disbetes,high totaⅠ cholesterol,high triglyceride,low high density lipoproteins,high low density lipoproteins and hyperuricemia were 26.7% （64/240）,11.7% （28/240）,35.4% （85/240）,25.4% （61/240）,13.3% （32/240）,4.2% （10/240）,4.6% （11/240）,respectively;the proportions of smoker and obesity were 31.7% （76/240） and 59.2% （142/240）.There were 42.5% （102/240） patients who had ≥3 risk factors;among them,the proportion in male was higher than that in female [54.8% （34/62） vs 38.2% （68/178）] （P 〈 0.05）,the proportion of different age had no significantly differences （P 〉0.05）.Totally 6.9% （11/160） had moderate high risks of 10-year ICVD.The risk of ICVD was higher than the reference in all ages except for male of 55-59 years old.Conclusion The risks of cardiovascular factors in patients with RA is high,particularly in patients of 35 to 59 years old.