Framingham风险评估对RA心血管受累的危险因素分析

Analysisof the Risk Factorsof Cardiovascular Involvement in RA by Framingham Risk Assessment

目的本文通过应用Framingham风险评估预测RA患者未来10年心血管疾病的发病几率,对RA患者心血管疾病患病的危险因素进行分析。方法对2012年9月至2013年4月就诊新疆自治区人民医院风湿免疫科符合标准的116例R A患者(男性26例,女性90例,平均年龄49.25±13.08岁),应用Framingham风险评估预测R A患者未来10年心血管疾病患病几率,根据其结果分为3组。比较各组的一般情况及实验室指标间的差异,并进一步行相关分析。结果 1.根据RA患者Framingham风险评估的结果进行分组(组I:患病几率<1%,组II:1%≤患病几率<5%,组III,患病几率≥5%),发现组II和组III的RA患者随着未来10年心血管疾病患病几率增加,CRP水平逐渐增高(11.15±8.15,23.74±22.77),组间比较差异有统计学意义(p<0.05)。行pearson相关分析,Framingham风险评估结果与RA处于活动期患者的CRP水平有直线相关关系(p<0.05),r值为0.085。2.随着R A患者未来10年心血管疾病患病几率增加,R F值逐渐增高(320.65±454.78,332.32±470.86,553.78±882.10),各组间比较差异有统计学意义(p<0.05)。行pearson相关分析,Framingham风险评估结果与R A患者R F值有直线相关关系(p<0.05),r值为0.047。3.随着R A患者未来10年心血管疾病患病几率增加,尿酸(UA)值逐渐增高(229.71±61.16,274.85±69.30,277.33±64.97),各组间比较差异有统计学意义(p<0.05)。行pearson相关分析,Framingham风险评估结果与RA患者UA值有直线相关关系(p<0.05),r值为0.037。结论类风湿关节炎不仅是一种关节疾病,也是一种多系统受累的结缔组织病,同时RA是增加心血管疾病的发生率和病死率风险的疾病之一。临床医师在类风湿关节炎疾病治疗过程中不仅要关注原发病的治疗反应,同时应注意CRP、RF值,监测UA水平的变化,以期早期发现RA患者心血管受累风险,早期预防及治疗,使RA患者提高生活质量,减少因心血管疾病所致的病死率。

Objective To analysis the risk factors for cardiovascular disease in patients with RA,by the application of Framingham risk assessment to predict risk of cardiovascular disease in the future 10 years of RA patients. Methods 116 patients with RA in our hospital between September 2012 to April 2013 were analysed retrospectively.（26 male, 90 female, mean age 49.25 ± 13.08 yearsold）, to predict risk of cardiovascular disease in the future 10 years of RA patients by Framingham risk assessment,according to the outcome,the patients were divided into 3 groups.The groups were compared with each other. Results 1.according to the different Framingham risk assessment results, with a progressive increase in risk of cardiovascular disease in the future 10 years of RA patients,CRP levels gradually increased in group II and group III（11.15 ± 8.15, 23.74± 22.77）,There was significant difference among the groups（P〈0.05）.Risk assessment results of Framingham correlated positively with CRP levels in active RA patients（r=0.085,p 0.05）. 2.With a progressive increase in risk of cardiovascular disease in the future 10 years of RA patients,RF levels gradually increased（320.65±454.78,332.32±470.86,553.78 ± 882.10）, Therewas significant differenceamong thegroups（P〈0.05）. risk assessment results of Framingham correlated positively with RF levels in RA patients（r=0.047,P〈0.05）. 3.With aprogressiveincreasein risk of cardiovascular disease in the future 10 years of RA patients,uric acid（UA） levels gradually increased（229.71±61.16,274.85± 69.30,277.33 ± 64.97）, There was significant differenceamongthegroups（P〉0.05）. Risk assessment results of Framingham correlated positively with UA levels in RA patients（r=0.037,P〈0.05）. Conclusion rheumatoid arthritis is not only a kind of joint disease, but also a connective tissue disease involvement of multi system.Meanwhile,RA is one of diseases increasing incidence and mortality of cardiovascular disease. Clinicians should pay attention not only to the treatment of primary disease in the treatment of rheumatoid arthritis, but also to CRP, RF levels, monitoring the changes of UA level, in order to detect cardiovascular involvement early,to prevent and treat patients with RA early, improve the life quality, reduce the mortality caused by cardiovascular disease.