J Rheumatol:类风湿关节炎心血管危险因素和疾病特征与动脉功能相关

2017-06-06 xiangting MedSci原创

传统的心血管危险因素和疾病特征与RA血管动力学变化一致。

动脉特征影响心血管疾病(CVD)风险。这项研究旨在明确类风湿关节炎(RA)动脉功能的潜在决定因素。

研究对象包括177例没有CVD的RA患者(118例白人,32例亚裔,22例黑人,5例混血),使用多变量逆向回归模型,计算传统心血管危险因素和RA特征与动脉硬度(脉搏波速度),波反射(增强指数,反射波压力和反射幅度)和压力脉动(中心收缩压和脉压,外周脉压,脉压增强,前波压)之间的关系。

记录的特征可以解释动脉功能37%(脉搏波速度)至71%(反射波压)的变异性。这些因素与波浪反射和压力波动尤其相关:RA持续时间(p = 0.04),类风湿因子情况(p = 0.01-0.03),白细胞计数(p = 0.02-0.05)和总胆固醇(p <0.01-0.03 )。体重指数(p <0.01-0.02)和胰岛素抵抗(p <0.01-0.01)与波反射和外周脉压降低有关。运动(p = 0.02)和饮酒量(p <0.01)与脉压放大升高和周围脉压降低有关。肿瘤坏死因子-α抑制(p <0.01)与脉搏波速度降低有关,使用四环素(p = 0.02)与外周脉搏压降低有关。

传统的心血管危险因素和疾病特征与RA血管动力学变化一致。RA中动脉硬度、波反射和压力波动对CVD风险的相对影响仍需要进一步研究。

原始出处:
Sule Gunter, Chanel Robinson, Gavin R. Norton,et al. Cardiovascular Risk Factors and Disease Characteristics Are Consistently Associated with Arterial Function in Rheumatoid Arthritis. J Rheumatol. June 2017. DOI: https://doi.org/10.3899/jrheum.170029

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    2017-06-08 lmm397
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    2017-06-06 Y—xianghai

    学习了新知识

    0

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对于TNF抑制剂反应不良的活动性RA患者,苏金单抗150mg的剂量可以改善体征和症状,减少疾病活动。

CLIN PHARMACOKINET:类风湿关节炎患者中Sarilumab和辛伐他汀药物相互作用

在活动性类风湿性关节炎(RA)的患者中会出现白细胞介素(IL)-6升高,能导致细胞色素P450(CYP)酶活性降低和由CYP代谢的药物浓度的变化。IL-6受体(IL-6R)拮抗剂的IL-6信号传导阻断可逆转IL-6的这种作用并恢复CYP活性。本研究评估了单剂量sarilumab治疗的RA患者(阻断IL-6Rα的人单克隆抗体[mAb])1周前后辛伐他汀(CYP3A4底物)的药代动力学特征,以评估潜在

Arthritis Rheumatol:抗瓜氨酸蛋白抗体与类风湿关节炎患者亲属痰中性粒细胞胞外菌网有关

FDRs的痰液抗CCP升高,包括血清阴性FDRs,这表明肺可能是这个人群中抗CCP产生的一个场所。

Arthritis Rheumatol:托珠单抗与肿瘤坏死因子抑制剂治疗类风湿关节炎的心血管安全性

这项基于多数据库的队列研究显示,从生物药物或托法替尼转换为TCZ或TNFi治疗的RA患者中,没有证据表明心血管危险性增加了。

Ann Rheum Dis:类风湿关节炎患者注意了!患糖尿病风险与这些有关

2017年5月,发表在《Ann Rheum Dis》的一项由美国科学家组织的研究,表明了类风湿关节炎患者中,改变病情的抗风湿药物和他汀与糖尿病风险有关。目的:旨在调查类风湿关节炎(RA)患者中,糖尿病的发病率,以及改变病情的抗风湿药物(DMARD)和他汀治疗的影响。方法:研究对象为2000~2014年,基线无糖尿病且参与风湿病国家数据库≥1年的RA患者。糖尿病根据自我报告或初始糖尿病药物进行确定。

J Rheumatol:类风湿关节炎病情恶化的评估:常用疾病活动指数的比较

在评估疾病加重或识别RA急性发作时,应该使用复合疾病活动指数、患者报告的疼痛和疾病活动、以及的医师报告的疾病活动。