类风湿关节炎患者发生心血管病的现状及未来

翻译 郑晓娟博士 审校 刘湘源

摘要 类风湿关节炎与心血管病事件(如心肌梗死和中风)的发生率升高有关。流行病学证据显示，传统心血管危险因素(如高血压、血脂异常、胰岛素抵抗、体质成分的改变)很重要, 但是不足以解释过高的风险。全身高度炎症及其与传统因素的相互作用可能与发病率升高有关。类风湿关节炎患者的传统危险因素与心血管危险因素之间的联系似乎并不直接，但也许可以用生物学改变来解释。为揭示发生这一现象的机制，建立识别高危人群的精确体系，设计和评估针对这部分患者的预防措施，有必要进行更多的研究。

附原文:Rheumatoid arthritis is associated with an increased risk for cardiovascular events, such as myocardial infarction and stroke. Epidemiological evidence suggests that classic cardiovascular risk factors, such as hypertension, dyslipidaemia, insulin resistance and body composition alterations are important but not sufficient to explain all of the excess risk. High-grade systemic inflammation and its interplay with classic risk factors may also contribute. Some associations between classic risk factors and cardiovascular risk in people with rheumatoid arthritis appear counterintuitive but may be explained on the basis of biological alterations. More research is necessary to uncover the exact mechanisms responsible for this phenomenon, develop accurate systems used to identify patients at high risk, design and assess prevention strategies specific to this population of patients.

引自: Kitas GD, Gabriel SE. Cardiovascular disease in rheumatoid arthritis: state of the art and future perspective. Ann Rheum Dis. 2010 Nov 24.