类风湿关节炎合并急性冠状动脉综合征患者血清脑钠肽水平及心功能临床观察

Clinical Observation of Serum Brain Natriuretic Peptide Level and Cardiac Function in Patients with Rheumatoid Arthritis Complicated with Acute Coronary Syndrome

目的探讨类风湿关节炎合并(ACS)患者血清脑钠肽水平及其心功能。方法选取2015年6月-2018年10月治的30例类风湿关节炎合并ACS患者作为观察组,另选30例不合并类风湿关节炎的ACS患者作为对照组,30例单类风湿关节炎患者无ACS患者作为未合并组,共90例。比较对照组、观察组与未合并组患者的传统心血管病危险因素,以及患者血清中的同型半胱氨酸(Hcy)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、红细胞沉降率(ESR)、高敏c反应蛋白(hs-CRP)及血清脑钠肽水平,使用左室射血分数(LVEF)来评价患者心功能,该分数采用彩色超声诊断仪进行测定。结果两者患者的传统心血管病危险因素(高血压,高血脂症,缺乏运动,饮酒,吸烟,家族病史)比较,差异无统计学意义(P>0.05)。观察组患者血清中LDL-C及TC水平与未合并组以及对照组进行比较,差异无统计学意义(P>0.05)。观察组患者血清中的Hcy、ESR及hs-CRP水平均高于未合并组以及对照组,差异有统计学意义(P<0.05)。观察组患者血清中的HDL-C水平与未合并组以及对照组进行比较,差异有统计学意义(P<0.05)。观察组患者血清脑钠肽水平高于对照组,差异具有统计学意义(P<0.05)。观察组患者LVEF水平低于对照组,差异具有统计学意义(P<0.05)。观察组患者血清脑钠肽、LVEF水平均高于未合并组,差异无统计学意义(P>0.05)。结论类风湿关节炎合并ACS患者LVEF水平低于不合并类风湿关节炎的ACS患者,血清脑钠肽水平比后者高,这可能与类风湿关节炎患者本身炎症导致心功能受损有关。

Objective To investigate the serum brain natriuretic peptide level and cardiac function in patients with rheumatoid arthritis complicated with ACS.Methods 30 patients with rheumatoid arthritis and ACS who were treated from June 2015 to October 2018 were enrolled as the observation group,30 patients with ACS but with no complication of rheumatoid arthritis were selected as the control group and 30 patients with rheumatoid arthritis but with no complication of ACS as the non-complication group.Traditional cardiovascular risk factors in the control,observation,and non-complication groups,as well as homocysteine (Hcy),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol in the serum of patients,alcohol (HDL-C),total cholesterol (TC),erythrocyte sedimentation rate (ESR),high-sensitivity c-reactive protein (hs-CRP) and serum brain natriuretic peptide levels were compared.Cardiac function in patients was evaluated by left ventricular ejection fraction (LVEF),and the score was measured by a color ultrasonic diagnostic apparatus.Results There were no significant differences in the traditional cardiovascular risk factors (hypertension,hyperlipidemia,lack of exercise,drinking,smoking,family history) between the two patients ( P >0.05).The serum levels of LDL-C and TC in the observation,non-complication and control groups were compared,and the difference was not statistically significant ( P >0.05).The levels of Hcy,ESR and hs-CRP in the serum of the observation group were higher than those in the non-complication and control groups,and the difference was statistically significant ( P <0.05).The serum levels of HDL-C were compared between the three groups,and the difference was statistically significant ( P <0.05).The serum brain natriuretic peptide level in the observation group was higher than that in the control group,and the difference was statistically significant ( P <0.05).The LVEF level of the observation group was lower than that of the control group,and the difference was statistically significant ( P <0.05).The serum levels of brain natriuretic peptide and LVEF in the observation group were higher than those in the non-complication group,and the difference was not statistically significant ( P >0.05).Conclusion The level of LVEF in patients with rheumatoid arthritis complicated with ACS is lower than that in patients with ACS without rheumatoid arthritis.Serum brain natriuretic peptide levels are higher than the latter,which may be related to impaired heart function in patients with rheumatoid arthritis.