RF、抗CCP抗体对类风湿关节炎患者并发心血管疾病的影响分析

Influence of RF and Anti-CCP Antibodies on Cardiovascular Disease in Patients with Rheumatoid Arthritis

目的探讨类风湿因子(RF)、抗环瓜氨酸肽(抗CCP)抗体对类风湿关节炎(RA)患者并发心血管疾病的影响。方法于2019年11月—2020年10月选取124例在该院治疗的RA患者为研究对象。所有患者均进行RF、抗CCP抗体检测,并行彩色多普勒超声心动图、心电图检查。根据患者是否并发心血管疾病分为合并组(n=38)和未合并组(n=86)。比较两组患者RF、抗CCP抗体水平,并绘制ROC曲线获取RF、抗CCP抗体对RA患者合并心血管疾病的曲线下面积(AUC)、最佳截断值(cut-off值)。以cut-off值为划界点,比较不同RF、抗CPP抗体水平患者心血管疾病的发生情况。结果合并组患者血清RF(187.32±31.67)U/mL、抗CCP抗体水平(316.72±44.87)RU/mL均高于未合并组(126.88±25.61)U/mL、(258.91±37.53)RU/mL,差异有统计学意义(t=11.247、7.438,P<0.05)。ROC曲线分析显示,血清RF、抗CCP抗体在ROC曲线下对RA患者合并心血管疾病的AUC分别为0.701、0.775,均具有显著的预测价值(P<0.05)。RF的cut-off值为156.74 U/mL,抗CCP抗体的cut-off值为284.63 RU/mL。RF≥156.74 U/mL的患者心血管疾病的总发生率(41.7%)高于RF<156.74 U/mL的患者(23.7%),差异有统计学意义(χ^(2)=4.476,P<0.05)。抗CCP抗体≥284.63 RU/mL的患者心血管疾病总发生率(56.4%)高于抗CCP抗体<284.63 RU/mL的患者(18.8%),差异有统计学意义(χ^(2)=17.770,P<0.05)。结论RA患者合并心血管疾病的发生率较高,RF、抗CCP抗体水平的变化可能与RA患者并发心血管疾病密切相关。

Objective To investigate the effect of rheumatoid factor(RF)and anti-cyclic citrullinated peptide(anti-CCP)antibody on cardiovascular disease in patients with rheumatoid arthritis(RA).Methods From November 2019 to October 2020,124 RA patients treated in the hospital were selected as the research objects.All patients underwent RF,anti-CCP antibody detection,and concurrent color Doppler echocardiography and electrocardiography.Patients were divided into a combined group(n=38)and an uncombined group(n=86)according to whether they had concurrent cardiovascular disease.The levels of RF and anti-CCP antibodies in the two groups were compared,and ROC curves were drawn to obtain the area under the curve(AUC)and the best cut-off value(cut-off value)of RF and anti-CCP antibodies for RA patients with cardiovascular disease.Taking the cut-off value as the cut-off point,the incidence of cardiovascular disease in patients with different RF and anti-CPP antibody levels was compared.Results The serum RF(187.32±31.67)U/mL,and anti-CCP antibody levels(316.72±44.87)RU/mL,in the combined group were higher than those in the uncombined group(126.88±25.61)U/mL,(258.91±37.53)RU/mL,the difference was statistically significant(t=11.247,7.438,P<0.05).The ROC curve analysis showed that the AUC of serum RF and anti-CCP antibody for RA patients complicated with cardiovascular disease under the ROC curve were 0.701 and 0.775,respectively,both of which had significant predictive value(P<0.05).The cut-off value of RF was 156.74 U/mL,and the cut-off value of anti-CCP antibody was 284.63 RU/mL.The overall incidence of cardiovascular disease in patients with RF≥156.74 U/mL(41.7%)was higher than that in patients with RF<156.74 U/mL(23.7%),and the difference was statistically significant(χ^(2)=4.476,P<0.05).The total incidence of cardiovascular disease in patients with anti-CCP antibody≥284.63 RU/mL(56.4%)was higher than that in patients with anti-CCP antibody<284.63 RU/mL(18.8%),and the difference was statistically significant(χ^(2)=17.770,P<0.05).Conclusion The incidence of cardiovascular disease in RA patients is high,and the changes of RF and anti-CCP antibody levels may be closely related to cardiovascular disease in RA patients.