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目的探讨类风湿关节炎(RA)患者血脂代谢、颈动脉粥样硬化斑块与疾病活动的关系。方法有颈动脉粥样硬化RA患者52例,分为活动期RA组(24例)和非活动期RA组(28例),比较两组患者血脂、高敏C反应蛋白(hsCRP)、红细胞沉降率(ESR)、颈动脉斑块面积、斑块厚度和颈动脉内中膜厚度(IMT),分析RA患者血脂、颈动脉斑块面积、斑块厚度和IMT与hsCRP、ESR的相关性。结果活动期RA组血清HDL-C水平低于非活动期RA组(P<0.05),活动期RA组hsCRP、ESR水平高于非活动期RA组(P<0.01),活动期RA组斑块厚度及IMT较非活动期RA组厚(P<0.05或P<0.01)。RA患者hsCRP、ESR与硬化颈动脉斑块面积、斑块厚度、IMT呈正相关(P<0.01),而与血清HDL-C水平呈负相关(P<0.01)。结论活动期RA患者血脂代谢紊乱及颈动脉粥样硬化斑块较非活动RA患者明显,并与RA疾病活动密切相关。
Objective To investigate the relationship between lipid metabolism, carotid atherosclerotic plaque and disease activity in patients with rheumatoid arthritis (RA). Methods Fifty-two patients with carotid atherosclerosis RA were divided into active RA group (24 cases) and inactive RA group (28 cases). The levels of serum lipids, high sensitivity C-reactive protein (hsCRP), erythrocyte sedimentation rate ESR, carotid plaque area, plaque thickness and carotid intima-media thickness (IMT). The correlation between serum lipid, carotid plaque area, plaque thickness and IMT, hsCRP and ESR was analyzed. Results The level of serum HDL-C in active RA group was lower than that in inactive RA group (P <0.05). The levels of hsCRP and ESR in active RA group were higher than those in inactive RA group (P <0.01) The thickness and IMT were thicker than inactive RA group (P <0.05 or P <0.01). Serum hsCRP and ESR were positively correlated with plaque area, plaque thickness and IMT in RA patients (P <0.01), but negatively correlated with serum HDL-C levels (P <0.01). Conclusion Serum lipids metabolism disorder and carotid atherosclerosis plaques in patients with active RA are more obvious than patients with inactive RA, and are closely related to the activity of RA.