CAJ | 학술논문

目的探讨类风湿关节炎(RA)心脏损害与实验室指标的关系.方法回顾性分析184例RA患者中有心脏损害的RA患者的超声心动图及心电图表现.结果 RA患者心脏损害在超声心动图上主要表现为肺动脉高压(8.3%,3/36)、瓣膜病(38.9%,14/36)、动脉硬化(27.8%,10/36)、室壁运动减低(13.9%,5/36)、心肌炎(5.6%,2/36)、心包积液(5.6%,2/36);心电图异常表现主要为窦性心动过速(15.22%,7/46)、ST-T改变(39.13%,18/46)、电轴左偏(8.70%,4/46)、分支阻滞(13.04%,6/46)、左心室肥厚(4.35%,2/46)、心房颤动(4.35%,2/46)、期前收缩(8.70%,4/46)、早期复极综合征(2.17%,1/46)、电轴右偏(4.35%,2/46);有心脏损害的RA患者C-反应蛋白(CRP)[(46.77±5.87)mg/L]明显高于无心脏损害的RA患者[(28.45±3.21)mg/L,P＜0.05],而2组间红细胞沉降率、类风湿因子、IgG、IgA、IgM、血小板计数比较差异无统计学意义(P均＞0.05);有心脏损害的RA患者超声心动图异常者各亚组间CRP值差异无统计学意义(P＞0.05).结论 RA患者有心脏损害者并不少见,超声心动图上主要表现为瓣膜病、动脉硬化、室壁运动减低、心包积液;心电图异常表现主要为窦性心动过速、ST-T改变、分支阻滞、期前收缩;有心脏损害的RA患者CRP明显高于无心脏损害的RA患者,提示较高的CRP对RA患者心脏损害有预示作用.
목적 탐토류풍습관절염(RA)심장손해여실험실지표적관계.방법 회고성분석184례RA환자중유심장손해적RA환자적초성심동도급심전도표현.결과 RA환자심장손해재초성심동도상주요표현위폐동맥고압(8.3%,3/36)、판막병(38.9%,14/36)、동맥경화(27.8%,10/36)、실벽운동감저(13.9%,5/36)、심기염(5.6%,2/36)、심포적액(5.6%,2/36);심전도이상표현주요위두성심동과속(15.22%,7/46)、ST-T개변(39.13%,18/46)、전축좌편(8.70%,4/46)、분지조체(13.04%,6/46)、좌심실비후(4.35%,2/46)、심방전동(4.35%,2/46)、기전수축(8.70%,4/46)、조기복겁종합정(2.17%,1/46)、전축우편(4.35%,2/46);유심장손해적RA환자C-반응단백(CRP)[(46.77±5.87)mg/L]명현고우무심장손해적RA환자[(28.45±3.21)mg/L,P＜0.05],이2조간홍세포침강솔、류풍습인자、IgG、IgA、IgM、혈소판계수비교차이무통계학의의(P균＞0.05);유심장손해적RA환자초성심동도이상자각아조간CRP치차이무통계학의의(P＞0.05).결론 RA환자유심장손해자병불소견,초성심동도상주요표현위판막병、동맥경화、실벽운동감저、심포적액;심전도이상표현주요위두성심동과속、ST-T개변、분지조체、기전수축;유심장손해적RA환자CRP명현고우무심장손해적RA환자,제시교고적CRP대RA환자심장손해유예시작용.
Objective To explore the relationship between cardiac involvement and laboratory indicators in patients with rheumatoid arthritis(RA). Methods Cardiac echocardiography and ECG performance of 184 patients with RA were analyzed retrospectively. Results Among the 184 patients with RA, the pulmonary hypertension detection rate was 8. 3%, valvular disease 38. 9%, arteriosclerosis 27. 8%, wall to reduce the exercise 13.9%, myocarditis 5.6% and pericardial effusion 5.6%, according to the echocardiography examinations;Sinus tachycardia was evidenced in 15. 22% patients, ST-T changes in 39. 13%, electric axis left side in 8. 70%, branch block in 13.04%, left ventricular hypertrophy in 4. 35%, atrial fibrillation in 4. 35%, premature in 8.70%, early repolarization syndrome in 2. 17% and electric-axis right side in 4. 35% patients by ECG examinations. The serum level of CRP (46. 77 ±5. 87) mg/L was significantly higher in RA patients with cardiac involvement than that in the non-cardiac involvement patientsm (28. 45 ±3. 21) mg/L (P ＜0.05) ;While the serum level of ESR,RF,IgG,IgA,IgM, PLT showed no statistically significant differences between the two groups (P ＞ 0.05); Within RA patients withcardiac involvement, the serum level of CRP showed no significant difference among different sub-groups , which were classified according to the echocardiography performance (P ＞ 0.05). Conclusions Cardiac involvement occurred frequently in patients with rheumatoid arthritis. The valvular disease, arteriosclerosis, reducing of the wall motion and pericardial effusion are the main manifestations by echocardiography examination; Sinus tachycardia, ST-T changes,branch block and premature beats are the main ECG abnormalities. The serum level of CRP is significantly higher in RA patients with cardiac involvement than that with non-cardiac involvement patients. The higher level of CRP in patients with RA may indicate the cardiac involvement presence.