早期类风湿关节炎患者血管超声评估与内皮功能的相关性研究

摘要

Objective To assess flow-mediated dilation in patients with early rheumatoid arthritis (RA) through ultrasound testing and to investigate its relationship with endothelial function related biological indicators. Methods 85 patients with early RA and 60 healthy subjects were selected. Endothelial dependent flow-mediated dilation (ED-FMD) of brachial artery was tested by ultrasound. Blood was drawn to analyze blood lipid, erythrocyte sedimentation (ESR), C-reactive protein (CRP), plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator (tPA), VonWillebrand factor (VWF), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cellular adhesion molecule-1 (sVCAM-1), sL se-lectin and monocyte chemotactic protein-1 (MCP-1). Logistic regression analysis was used to compare variables between groups. Simple and multiple linear regression analysis were used to analyze ED-FMD and biomarkers. Results The levels of sICAM-1, MCP-1 and VWF in RA group were significantly higher than those of the control group (P <0. 05). Regression a-nalysis showed that ED-FMD was positively correlated with SL selectin in RA group (simple linear regression analysis: β = 4.961, P = 0.004; multiple linear regression analysis: (3=5.452, P =0.005). Conclusion Vascular activity is elevated in early RA patients. ED-FMD of RA patients is related with sL-selectin.%目的 通过超声检查评估早期类风湿关节炎(RA)患者的血管舒张功能,探讨其与内皮功能相关生物指标的关系.方法 选取85例早期RA患者(RA组)和60例健康受试者(对照组)进行研究,超声检查肱动脉血流介导的内皮依赖性血管舒张(ED-FMD),采集血液标本分析血脂、红细胞沉降率(ESR)、C反应蛋白(CRP)、纤溶酶原激活物抑制剂-1(PAI-1)、组织型纤溶酶原激活物(tPA)、VonWillebrand因子(VWF)、可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞黏附分子-1(sVCAM-1)、sL选择素和单核细胞趋化蛋白-1(MCP-1).组间变量比较采用Logistic回归分析,ED-FMD和生物指标的分析采用一元直线回归及多元线性回归分析.结果 RA组患者sICAM-1、MCP-1及VWF水平高于对照组,差异有统计学意义(P＜0.05).回归分析显示,RA组患者ED-FMD与sL选择素呈正相关(一元直线回归分析:β=4.961,P=0.004;多元线性回归分析:β=5.452,P=0.005).结论 早期RA患者血管内皮活性较强,ED-FMD与内皮功能相关的生物指标sL选择素有关.