类风湿关节炎血浆D-二聚体水平与颈动脉粥样硬化的相关性分析

Correlation between plasma D-dimer level and carotid atherosclerosis in patients with rheumatoid arthritis

目的探讨类风湿关节炎(RA)患者血浆D-二聚体(D-Dimer)与颈动脉粥样硬化(CAS)的相关性。方法取2018年1月至2019年1月西安市第五医院门诊及住院RA组患者75例作为RA组,另选择同期健康体检者70例作为对照组。比较2组血浆D-Dimer水平差异,同时比较不同疾病活动期RA组患者血浆D-Dimer水平差异;采用高频超声检测RA患者和对照组的颈总动脉内中膜厚度(CIMT),比较RA组与对照组CIMT值差异,同时比较RA组中合并CAS与未合并CAS患者血浆D-Dimer水平的差异。采用Spearman相关分析RA患者血浆D-Dimer水平与RA疾病活动及CIMT值的相关性。结果RA组患者血浆D-Dimer水平高于对照组,其中RA疾病活动组血浆D-Dimer水平高于RA非疾病活动组(P<0.05)。RA组患者CIMT值高于对照组,其中RA疾病活动组CIMT值高于RA非疾病活动组(P<0.05)。RA组中合并CAS患者的血浆D-Dimer水平明显高于未合并CAS患者。Spearman相关分析显示,血浆D-Dimer水平与RA疾病活动及CIMT值呈正相关(r s=0.154,P<0.05)。结论RA患者发生颈部动脉硬化的概率明显升高,且疾病活动期可促进颈部动脉硬化的形成。血浆D-Dimer水平升高与RA患者病情活动性及CAS发生存在相关性,并成为RA患者发生CAS的危险因素。

Objective To investigate the correlation between D-dimer and carotid atherosclerosis(CAS)in patients with rheumatoid arthritis(RA).Methods A total of 75 patients with RA who were treated in our hospital from January 2018 to January 2019 were enrolled as Ra group,at the same time,the 70 healthy subjects who underwent physical examination were enrolled as control group.The D-dimer levels in RA group were dtected and compared with those in control group.The common carotid intima-media thickness(CIMT)was measured by high frequency ultrasound.And the D-dimer levels were observed and compared between the patients with CAS and the patients without CAS.Moreover Spearman correlation was used to analyze the correlation between D-dimer levels and disease activity as well as CIMT value in patients with RA.Results The plasma levels of D-dimer in RA group were significantly higher than those in control group,moreover,which in active RA group were significantly higher than those in non active RA group(P<0.05).The CIMT values in RA group were significantly higher than those in control group,moreover,which in active RA group were significantly higher than those in non active RA group(P<0.05).In addition the D-dimer levels in RA patients with CAS were significantly higher than those in RA patients without CAS.Spearman correlation analysis showed that plasma D-dimer levels were positively correlated with RA disease activity and CIMT(P<0.05).Conclusion The incidence of carotid atherosclerosis in patients with RA is significantly increased,and the active stage of disease can promote the formation of carotid atherosclerosis.And the increase of plasma D-Dimer level is correlated with the disease activity of patients and the incidence of CAS,which becomes a risk factor for the pathogenesis of CAS in patients with RA.