基于Framingham评分的银屑病患者心血管风险评估

Relation between psoriasis features and Framingham cardiovascular risk assessment

目的银屑病患者发生心血管病的危险因素较普通人群更加常见。文中通过对寻常型银屑病患者和正常体检人群进行Framingham心血管风险评估,旨在讨论银屑病患者心血管病发生风险的特征及防治。方法选取2015年10月至2016年10月期间南京军区南京总医院门诊90例寻常型银屑病患者,其中轻度48名(53.33%)、重度42名(46.67%);并纳入137名正常体检者作为对照。所有寻常型银屑病患者均进行临床和组织病理学诊断,使用银屑病面积和严重程度指数(PASI)评分评估其严重性。检测血脂、血压和空腹血糖等指标,计算未来10年发生心血管病的Framingham风险评分(FRS)。结果寻常型银屑病患者的10年FRS[1(0.5,6.0)]显著高于对照者[0.5(0.5,2.0)],差异有统计学意义(P<0.05);10年FRS与性别(r=0.358)、年龄(r=0.678)和病程(r=0.257)呈正相关(P<0.05),与病情严重程度无相关性(r=0.184,P>0.05)。轻度与重度银屑病患者10年FRS差异无统计学意义(P>0.05)。男性患者和50岁以上的老年患者FRS显著增高(P<0.05)。结论寻常型银屑病患者尤其是老年男性患者,与正常体检人群相比具有较高的心血管病发生风险。故应对银屑病患者的心血管疾病进行风险评估,并对其并发症进行积极防治。

Objective Many studies have suggested that cardiovascular risk factors seem to be more common in psoriasis pa- tients than in general population. In this study we aimed to investigate the prevention and treatment of cardiovascular risk in psoriasis patients by Framingham cardiovascular risk assessment in patients with psoriasis vulgaris and normal people using Framingham score. Methods We conducted a prospective study including 90 outpatients with psoriasis vulgaris and 137 controls without psoriasis from October 2015 to October 2016 in our hospital. All psoriasis patients were diagnosed clinically and histopathologically. The severity of psoriasis was assessed according to the psoriasis area and severity index （PASI） score. Along with a thorough medical history and phys- ical examination, serum lipid profile, blood pressure and fasting plasma glucose tests were carried out. The lO-year Framingham risk score （FRS） for general cardiovascular disease included indexes concerning age, gender, total cholesterol, HDL-cholesterol, systolicblood pressure and smoking history. Results We found the 10-year FRS was significantly higher in patients with psoriasis vulgaris than in controls （P〈0.05）. The 10-year FRS was in positive relation with gender（ r= 0.358） , age（ r=0.678） and course of disease（ r= 0.257）. No relation has been found in 10-year FRS and psoriasis features（ r= 0.184, P〉0.05）. No significance was found in the 10-year FRS of pa-tients with mild and severe psoriasis （P〉0.05）. FRS was significantly higher in male patients and in patients above 50 years old （P〈 0.05）. Conclusion Psoriasis patients, especially the older male patients, tend to have high risks of cardiovascular disease. There- fore, risk assessment for cardiovascular diseases should be conducted in psoriasis patients, and complications should be actively pre- vented and treated.