Comparative study for cardiovascular risk factors of rheumatoid arthritis and osteoarthritis

目的：比较类风湿关节炎和骨关节炎患者心血管危险因素的差异.方法：回顾性比较44例类风湿关节炎患者（RA）和36例骨关节炎患者（OA）的心血管疾病相关影响因素的差异.包括性别、年龄、身体质量指数、病程、颈动脉超声相关指标、同型半胱氨酸、血脂水平、炎症相关指标及超声心动相关指标等.结果：（1）一般情况：两组患者在性别、年龄方面无明显差异（P〉0.05）,在体重指数方面,OA组体重指数显著高于RA组（P=0.018）,在病程方面,RA组病程显著长于OA组（P=0.024）;（2）实验室指标：RA组患者同型半胱氨酸水平显著高于OA组（P=0.002）;两组患者总胆固醇、甘油三酯、低密度脂蛋白、载脂蛋白B、高密度脂蛋白比较均无明显差异（P〉0.05）,但RA组载脂蛋白A1水平显著低于OA组（P〈0.001）,脂蛋白α水平显著高于OA组（P〈0.001）;RA组患者的血沉、C反应蛋白较OA组水平显著升高（P〈0.001）;（3）超声评价：在心脏超声方面,RA组患者每搏输出量、射血分数明显低于OA组（P=0.022,P=0.009）;两组患者主动脉内径、左心房内径、左室舒张末期内径、左室收缩末期内径、左室后壁厚度、左室短轴缩短率、右心室内径、右心房内径、及室间隔厚度比较均无明显差异（P〉0.05）;两组患者颈动脉斑发生率无明显差异（P〉0.05）,但两组患者颈动脉增厚的发生率及颈动脉中层厚度比较均有明显差异（P〈0.001）.结论：RA患者发生心血管事件的概率比OA高,积极控制RA病情,可能降低心血管事件的发生.

Objective： To compare the difference of cardiovascular risk factors in patients with rheumatoid arthritis （RA） and osteoarthritis （OA）. Methods： A retrospective analysis was performed to compare the difference of cardiovascular factors between 44 patients with RA and 36 patients with OA in terms of their gender, age, body mass index, course of disease, carotid ultrasound related indicators, homocysteine, blood lipid levels, inflammation index, echocardiographic index, etc. Results： （1） General situation： there was no significant difference between two groups in terms of gender and age （P 〉 0.05）. However, body mass index of OA group was significantly higher than that of RA group and the course of disease of RA group was significantly longer than that of OA group （P = 0.024）. （2） Laboratory index： the level of homocysteine of RA group was significantly higher than that of OA group （P = 0.002）. Though there was no significant difference between these two groups in terms of total cholesterol, triglyceride, low density lipoprotein, apolipoprotein B and high density lipoprotein （P 〉 0.05）, the level of apolipoprotein A1 of RA group was significantly lower than that of OA group （P 〈 0.001） and the level of lipoprotein A of RA group was significantly higher than that of OA group （P 〈 0.001）. The levels of erythrocyte sedimentation rate and C reactive protein of group RA were significantly higher than those of OA group （P 〈 0.001）. （3） Stroke volume and ejection fraction of echocardiography of RA patients were significantly lower than those of OA patients （P = 0.022, P = 0.009）. However, there was no significant difference between two groups in terms of aortic diameter, left atrial diameter, left ventricular end diastolic diameter, left ventricular end systolic diameter, left ventricular posterior wall thickness, left ventricular fractional shortening, right ventricular diameter, right atrial diameter, and interventricular septum thickness （P 〉 0.05）. Though significant difference in carotid artery plaque incidence between the two groups was not observed （P 〉 0.05）, the incidence of carotid artery thickening and carotid artery middle thickness were significantly different between the two groups （P 〈 0.001）. Conclusion： The rate for the occurrence of cardiovascular events in patients with RA was higher than those with OA. Additionally, effective control of RA patients’ conditions has the potential to reduce the risk of cardiovascular events.