类风湿关节炎合并心血管疾病的危险因素分析

Risk factors analysis on rheumatoid arthritis combined with cardiovascular disease

目的:探讨类风湿关节炎(RA)患者合并心血管疾病(CVD)的危险因素,为临床预防治疗提供依据。方法:采用回顾性病例分析方法,选择安徽中医药大学第一附属医院风湿病科2016年1月1日至5月31日入院的RA患者200例,详细记录患者的一般资料、安全性指标、炎性指标、生化指标、心功能指标及心电图数据,采用单因素方差分析和Logistic多元回归分析,筛选RA合并CVD的危险因素。结果:200例患者中合并CVD共78例,占总人群的39%。单因素分析提示RA合并CVD发生的风险与年龄、病程、DAS28评分、RF、ESR、CRP、LDLC、TC、CCP、GLU、RVDd、LVDd、EF、FS有关(P<0.05)。多因素分析提示RA合并CVD发生的风险与GLU(OR=2.295)、TC(OR=1.697)、DAS28评分(OR=1.258)、ESR(OR=1.016)、CRP(OR=1.004)、CCP(OR=1.002)、RF(OR=1.000)有关(P<0.05)。结论:类风湿关节炎增加了心血管疾病发生的风险,其发生不仅与血糖、总胆固醇、年龄等传统因素有关,还与病程、DAS28、ESR、CRP、RF等免疫炎性指标密切相关。

Objective: To investigate the risk factors of rheumatoid arthritis(RA) combined with cardiovascular diseases(cardiovascular damage, CVD), and provide the basis for the prevention and treatment in clinical. Methods: Using retrospective case analysis method, 200 RA patients admitted to Rheumatology Department of Anhui Traditional Chinese Medicine Hospital from 2016.1.1 to 2016.5.31 were selected. The general information, safety index, inflammation index, biochemical index, cardiac function index and electrocardiogram data of patients were recorded in detail. The risk factors of RA combined with CVD were screened by one-way ANOVA and Logistic multiple regression analysis. Results: Among the 200 patients, 78 patients were combined with CVD, accounting for 39% of the total population;One-factor analysis of variance indicated that the risk of RA with CVD was related to age, course of disease, DAS 28 score, RF, ESR, CRP, LDLC, TC, CCP, GLU, RVDd, LVDd, EF, FS(P<0.05). Multivariate analysis of variance indicated that the risk of RA combined with CVD was related to GLU(OR=2.295), TC(OR=1.697), DAS 28(OR=1.258), ESR(OR=1.016), CRP(OR=1.004), CCP(OR=1.002), RF(OR=1.000)(P<0.05). Conclusion: Rheumatoid arthritis increases the risk of cardiovascular disease, which is not only related to traditional factors such as blood glucose, total cholesterol, age, but also closely related to the course of disease, DAS 28, ESR, CRP, RF and other immunoinflammatory indicators.