作者：van der Valk FM 翻译：邢瑞 校对：杨麟

摘要：背景：强直性脊柱炎（AS）是一种慢性炎症性疾病，主要累及脊柱和骶髂关节。此外，患者心血管疾病（CVD）的风险增加，这可能是由于动脉壁的炎症活动增强。在本研究中，我们应用18F-脱氧葡萄糖（FDG）正电子发射断层显像CT检测患者和健康对照的颈动脉壁的炎症水平。他汀治疗可减少动脉壁炎，随后我们评估了他汀类药物治疗3个月的对强直性脊柱炎动脉壁炎症的作用。

方法和结果：我们入组24名无心血管疾病史的患者（年龄44±10岁，72%为男性），对照组选取20名年龄和性别匹配的健康人。与对照组相比，AS组低密度脂蛋白胆固醇和C-反应蛋白水平升高。两组的10年心血管疾病风险为2%。尽管如此，AS组动脉壁的18F-FDG摄取与对照组相比增加了20%。40?毫克/日的阿托伐他汀治疗3个月显著下调低密度脂蛋白胆固醇（基线3.55±1.15?mmol／L，53%）和CRP（基线5（1.5-9.3）mg/L，58%）的水平，且颈动脉壁炎症随之下降（最大目标背景的比例从1.90±0.27降为1.67±0.27；P = 0.009）。

结论：无其他心血管疾病危险因素的AS患者的动脉壁炎症增加，他汀类药物治疗可减少炎症。目前的心血管预防指南中没有将AS认定为风险因素。我们的数据支持修改心血管疾病的管理指南，可能是早期他汀类药物治疗的作用。

附原文：BACKGROUND: Ankylosing spondylitis (AS) is a chronic inflammatory disease with involvement of axial and sacroiliac joints. In addition, patients with AS have increased risk of cardiovascular disease (CVD), which might be attributed to enhanced inflammatory activity of the arterial wall. In the present study, we compared the level of carotid arterial wall inflammation in patients with AS with healthy controls using 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography with CT. As arterial wall inflammation is reduced by statin therapy, we subsequently assessed the effect of 3-month statin therapy on arterial wall inflammation in AS. METHODS AND RESULTS: We included 24 patients with AS (age 44±10, 72% males) without a history of CVD and 20 controls matched for age and gender. Patients with AS had lower high-density lipoprotein cholesterol and increased C reactive protein (CRP) compared with controls. The 10-year CVD risk was 2% in both groups. Notwithstanding, patients with AS had a 20% increase in arterial wall 18F-FDG uptake compared with controls. Three-month atorvastatin 40?mg daily significantly lowered low-density lipoprotein cholesterol (baseline 3.55±1.15?mmol/L, -53%) and CRP (baseline 5.0 (1.5-9.3) mg/L, -58%) with a concomitant decrease of carotid arterial wall inflammation (maximum target-to-background ratio from 1.90±0.30 to 1.67±0.27; p=0.009). CONCLUSIONS: Patients with AS and without other CVD risk factors have increased arterial wall inflammation, which decreases upon statin therapy. These subjects are not identified as being at risk in current cardiovascular prevention guidelines. Our data support the need to revise CV disease management in AS, with perhaps a role for early statin therapy.引自：van der Valk FM, Bernelot Moens SJ, Verweij SL, et al. Increased arterial wall inflammation in patients with ankylosing spondylitis is reduced by statin therapy. Ann Rheum Dis. 2016 Apr;75(4):721-9.