类风湿关节炎患者血脂代谢、颈动脉粥样硬化斑块与疾病活动的关系

Relationship of blood lipid metabolism and carotid atherosclerotic plaque with disease activity in patients with rheumatoid arthritis

目的探讨类风湿关节炎(RA)患者血脂代谢、颈动脉粥样硬化斑块与疾病活动的关系。方法有颈动脉粥样硬化RA患者52例,分为活动期RA组(24例)和非活动期RA组(28例),比较两组患者血脂、高敏C反应蛋白(hsCRP)、红细胞沉降率(ESR)、颈动脉斑块面积、斑块厚度和颈动脉内中膜厚度(IMT),分析RA患者血脂、颈动脉斑块面积、斑块厚度和IMT与hsCRP、ESR的相关性。结果活动期RA组血清HDL-C水平低于非活动期RA组(P<0.05),活动期RA组hsCRP、ESR水平高于非活动期RA组(P<0.01),活动期RA组斑块厚度及IMT较非活动期RA组厚(P<0.05或P<0.01)。RA患者hsCRP、ESR与硬化颈动脉斑块面积、斑块厚度、IMT呈正相关(P<0.01),而与血清HDL-C水平呈负相关(P<0.01)。结论活动期RA患者血脂代谢紊乱及颈动脉粥样硬化斑块较非活动RA患者明显,并与RA疾病活动密切相关。

Objective To investigate the relationship of blood lipid metabolism and carotid atherosclerotic plaque with disease activity in the patients with rheumatoid arthritis（RA）.Methods A total of 52 RA patients with carotid atherosclerosis was divided into two groups of A（RA in active stage,24cases）and B（RA in non-active stage,28cases）.Blood lipids,high sensitive C reactive protein（hsCRP）,erythrocyte sedimentation rate（ESR）,carotid plaque area,plaque thickness and intimamedia thickness（IMT）were compared between two groups.The correlation of blood lipid,carotid plaque area,plaque thickness and IMT with hsCRP and ESR was analyzed.Results Compared to group B,the patients of group A had lower HDL-C（P〈0.05）,higher levels of hsCRP and ESR（P〈0.01）,and thicker carotid plaque thickness and IMT（P〈0.05 or P〈0.01）.hsCRP and ESR were positively correlated with carotid plaque area,plaque thickness and IMT,but negatively correlated with HDL-C level in RA patients（P〈0.01）.Conclusion RA patients in active stage has obvious lipid metabolism disorder,which is closely related to the activity of RA diseases.