类风湿性关节炎合并颈动脉硬化的临床研究

Clinical study of rheumatoid arthritis complicated with carotid atherosclerosis

目的探讨类风湿性关节炎(RA)患者合并颈动脉硬化的危险因素。方法选取2014年1月至2018年6月本院收治的62例RA患者,根据有无颈动脉斑块分为斑块组和无斑块组,选择同期46名健康体检者为对照组,比较不同组别一般临床特征、RF、抗CCP、炎症指标、25羟维生素D,分析RA患者颈动脉硬化的危险因素。结果 RA组颈动脉斑块比例明显高于对照组(P<0.05),RA患者中,斑块组年龄、类风湿因子均高于无斑块组(P<0.05),25羟维生素D低于无斑块组(P<0.05);Logistic回归显示,高龄、类风湿因子增高、低水平的25羟维生素D是RA合并颈动脉硬化的危险因素。结论 RA患者和健康人群相比,颈动脉硬化的发生率明显增高,高龄、类风湿因子增高、低水平的25羟维生素D是RA患者合并动脉硬化的危险因素,补充维生素D可能可以降低RA患者发生动脉硬化的风险。

Objective To investigate the risk factors of carotid atherosclerosis in patients with rheumatoid arthritis.Methods 62 patients with RA treated in our hospital from January 2014 to June 2018 were divided into two groups according to the presence of carotid plaque.46 healthy subjects were selected as the control group at the same time.The general clinical characteristics,RF,anti-CCP,inflammation indicator and 25-hydroxyvitamin D were compared between different groups,and the risk factors for carotid atherosclerosis in RA patients were analysed.Results The proportion of carotid plaque in the RA group was significantly higher than that in the control group(P<0.05).The age and rheumatoid factor of the plaque group were higher than those of the non-plaque group(P<0.05).The 25-hydroxyvitamin D in the plaque group was lower than in the non-plaque group(P<0.05).Logistic regression showed that older age,increased rheumatoid factor,and low levels of 25-hydroxyvitamin D were risk factors for carotid atherosclerosis in RA patients.Conclusion The incidence of carotid atherosclerosis is significantly higher in patients with RA than in healthy people.Older age,increased rheumatoid factor,and low levels of 25-hydroxyvitamin D were risk factors for arteriosclerosis in patients with RA.Vitamin D supplementation may reduce the risk of arteriosclerosis in patients with RA.