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类风湿性关节炎患者因心脏疾病死亡的比率降低

2015-11-08 QQduhq 译 MedSci原创

占坑

根据美国风湿病学院在旧金山的年度会议内容,类风湿性关节炎患者患心血管疾病的几率加倍。
炎症是导致血管损伤和心脏疾病的危险因素之一。类风湿性关节炎(RA)患者机体的炎症更加活跃,不仅会导致关节活动受限。而且其他器官和组织也会因此受到损伤。 


类风湿性相关性炎症会导致机体血管的收缩和斑块的形成,减少血液流动。当斑块阻碍血流运行,它们可能堵塞小血管,导致民众罹患心脏病或中风等疾病。类风湿性关节炎患者的心脏内壁也会出现炎症,因此民众患心脏疾病的风险加剧。RA可以导致心包炎症,导致民众忍受剧烈的胸痛困扰。此外,RA患者房颤、心律失常、心力衰竭、中风和死亡的风险增加。根据以上种种,研究人员认为,保护RA患者心脏和关节的关键在于控制患者体内的炎症反应。

既往研究表明,RA患者在确立诊断一年内,出现心脏问题的风险加倍。确立诊断1-4年内,RA患者出现心脏病发作的危险增加60%,出现冠心病、心绞痛和死亡的风险增加50%。 

虽然研究人员对类风湿性关节炎起病原因及治疗尚不能完全清楚明白,但是RA患者的心脏病风险需要尽早解决,以避免对患者造成不必要的损失和伤害。 

罗彻斯特市梅奥诊所风湿病学家Elena Myasoedova博士,对2组患有RA且10年内死于心脏疾病的患者的相关数据进行了调查和分析。

一组患者为2000-2007年被诊断患有RA的315名患者;另一组患者为1980-1990年被诊断患有RA的498名患者。对照组民众未患RA但死于心脏病,共813人。大约2/3的参与人员为女性,平均年龄为60岁。 

1980-1990年死于心脏病的RA患者所占比例为7.9%;相比之下,2000-2007年为2.8%。死于冠状动脉疾病的RA患者所占比例也降低。2000-2007年,患有冠状动脉疾病的RA患者为1.2%,与普通人群相似;1980-1990年,冠状动脉疾病的RA患者为4.7%。 

他们需要进行更多的研究来证实为什么死于心脏病的类风湿性关节炎患者所占比率降低,但是医务人员仍然需要检查RA患者的心脏功能以警惕心脏问题,治疗心脏病和风湿性关节炎。

原始出处:

Cardiovascular risk falls in patients with rheumatoid arthritis.MNT.Nov 8,2015

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    2015-11-10 lmm397
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