强直性脊柱炎患者心脏受累危险因素研究

Study of the risk factors for cardiac involvement in the patients with ankylosing spondylitis

目的探讨强直性脊柱炎（AS）患者心脏受累的患病率,观察心脏受累的表现,并分析年龄、性别、病程、实验室指标及长期激素治疗、长期免疫抑制剂治疗与AS心脏受累的相关性。方法回顾性分析2014年1月~2015年11月我院确诊的AS住院患者131例（A组）,其中合并心脏受累即ECG和（或）UCG异常的患者为研究组（A1组）61例（46.56%）,无心脏受累的患者作为对照组（A2组）70例（53.43%）。同时选取217名我院体检中心均行ECG和UCG检查的体检者作为正常组（B组）。比较A1、A2组的相关实验室指标。对单因素组间比较有统计学意义的可疑危险因素进行Logistic回归分析,确定危险因素。结果 A组患者出现心脏受累的患病率为46.56%（61/131）,而B组为22.58%（49/217）,2组间比较差异有统计学意义（P〈0.05）。A1组与A2组之间年龄、病程、吸烟、饮酒、HLA-B27、长期免疫抑制剂治疗差异无统计学意义（P〉0.05）;ESR、Hb、性别、长期激素治疗差异有统计学意义（P〈0.05）。Logistic回归分析显示长期激素治疗及高ESR值是AS患者心脏受累的危险因素。结论长期激素治疗及高ESR值是AS患者发生心脏受累的危险因素。

Objective To explore the prevalence rate of cardiac involvement in the patients with ankylosing spondylitis（AS）,to observe the performance of cardiac involvement,and to analyze the correlations of AS cardiac involvement with age,gender,course of disease,laboratory indices,long-term hormone treatment,and long-term immunosuppressor treatment. Methods 131 hospitalized patients with AS（group A） who were diagnosed in our hospital from January 2014 to November 2015 were retrospectively analyzed.Among them,61 patients（46.56%） complicated with cardiac involvement i.e.ECG and（or） abnormal UCG were selected in the research group（group A1）,and the patients without cardiac involvement（53.43%） were selected in the control group（group A2）.217 people who were given ECG and UCG examinations in the physical examination center in our hospital were selected as the healthy group（group B） at the same time.Relevant laboratory indices were compared between group A1 and group A2.Logistic regression analysis was carried out for susceptible risk factors which were statistically significant in the univariate intra-group comparison,and risk factors were determined. Results The prevalence rate of cardiac involvement in group A was 46.56%（61/131）,and that in group B was 22.58%（49/217）,the differences between two groups were statistically significant（P0.05）.There were no statistically significant differences between group A1 and group A2 in terms of age,course of disease,smoking,alcohol drinking,HLA-B27 and long-term immunosuppressor treatment（P0.05）.There were statistically significant differences of ESR,Hb,gender and long-term hormone treatment（P 0.05）.According to the logistic regression analysis,long-term hormone therapy and high ESR value were risk factors for cardiac involvement in the patients with AS. Conclusion Long-term hormone therapy and high ESR value are risk factors for cardiac involvement in the patients with AS.