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目的:类风湿性关节炎(Rheumatoid arthritis,RA)是一种免疫失调的异质疾病,死亡率与心血管病的死亡危险有密切的联系。为了进一步验证以上假说,我们进行了年龄,性别匹配的病例对照研究,以探索在高原地区RA与多支冠状动脉病的危险因素之间的关系。方法:来自我院203例冠状动脉病(CAD)患者,平均年龄(66.5±8.2)岁。居住2200m~3500m高原地区达(13~23)年。全部患者分为研究组(n=75,RA+CAD)和对照组(n=128,CAD),进行第一次冠状动脉造影和胆固醇水平、血压等分析;其中27人从周围血中获得T细胞;24例稳定型心绞痛患者做对照组;单核细胞用高速离心机分离,表面染色采用反CD4fitc和反CD28pe抗体方法。结果统计分析采用了SAS软件分析。结果:RA患者有更明显的冠状动脉受累(P=0.002),无明显冠脉改变的仅占RA患者的4%。病变血管数量的逻辑回归分析表明,经调整年龄、性别和高血脂症后,RA仍是多支血管病变的重要危险因素。卡普兰-迈耶生存率曲线表明RA+CAD的存活概率比仅有CAD的患者要低(P=0.10),存活概率最低的是三个血管受累的患者,而且病变血管越多,死亡将大大增加(P=0.06)。结论:研究表明,高原地区的RA患者在他们做第一次动脉造影时,发现冠状动脉硬化的可能较大,这可能是由于RA是多支动脉病变发生的独立于传统心血管病的危险因素之外的危险因素。
AIM: Rheumatoid arthritis (RA) is a heterogeneous disease of immunological disorders. Mortality is closely linked to the risk of death from cardiovascular disease. To further validate the above hypothesis, we conducted a case-control study of age and gender parity to explore the association between RA and multiple coronary artery disease risk factors in the highlands. Methods: From our hospital 203 cases of coronary artery disease (CAD) patients, the average age (66.5 ± 8.2) years. Living 2200m ~ 3500m Plateau up to (13 ~ 23) years. All patients were divided into the study group (n = 75, RA + CAD) and control group (n = 128, CAD) for the first coronary angiography and cholesterol levels, blood pressure and other analysis; 27 of them from the peripheral blood to obtain T Cells; 24 patients with stable angina pectoris patients as control group; monocytes were separated by high-speed centrifuge, the surface staining using anti-CD4fitc and anti-CD28pe antibody method. The results of the statistical analysis using SAS software analysis. RESULTS: Patients with RA had a more significant coronary involvement (P = 0.002) and only 4% of patients with RA who did not have a significant coronary change. Logistic regression analysis of the number of diseased vessels showed that RA was still an important risk factor for multivessel disease after adjusting for age, gender and hyperlipidemia. The Kaplan-Meier survival curves showed that the survival probability of RA + CAD was lower than that of patients with CAD alone (P = 0.10). The three patients with the lowest survival probability were those with vascular involvement, and the more the diseased vessels, the more deaths would be. Increase (P = 0.06). CONCLUSIONS: Studies have shown that patients with RA in the plateau may find coronary artery disease more likely at the time of their first angiography, possibly due to the fact that RA is a risk factor for multiple arterial disease that is independent of conventional cardiovascular disease Outside the risk factors.