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題名 | Systolic Blood Pressure Is a Useful Measure in Predicting the Risk of Endothelial Dysfunction in Patients with Rheumatoid Arthritis=收縮壓為預測類風濕性關節炎病患內皮細胞功能失調之重要指標 |
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作者 | 黃詩茜; 魏正宗; 吳得進; 黃怡嘉; Huang, Shih-chien; Wei, James Cheng-chung; Wu, Der Jinn; Huang, Yi-chia; |
期刊 | 臺灣營養學會雜誌 |
出版日期 | 20120300 |
卷期 | 37:1 2012.03[民101.03] |
頁次 | 頁14-24 |
分類號 | 415.695 |
語文 | eng |
關鍵詞 | 類風濕性關節炎; 內皮細胞功能; 冠狀動脈疾病; 收縮壓; Rheumatoid arthritis; Endothelial function; Coronary artery disease; Systolic blood pressure; |
中文摘要 | 心血管疾病已證實為造成類風濕性關節炎病患死亡的主因之一。其可能原因眾多但研究結果卻不一致。本研究目的為探討類風濕性關節炎病患之心血管疾病危險因子與其內皮細胞功能的相關性。研究設計以橫斷式進行。由免疫風濕科門診募集43位類風濕性關節炎病患,依肱動脈血管擴張程度將病患分為內皮細胞功能正常組(n=29)及內皮細胞功能異常組(n=14),並由心臟內科募集33位冠狀動脈疾病病患。抽取病患空腹血分析血液生化值、脂質濃度、血清葉酸及維生素B-12、血漿同半胱胺酸及維生素B-6、發炎反應。結果顯示內皮細胞功能異常之病患其收縮壓有顯著較高的情形。調整相關因子後,收縮壓為造成病患內皮細胞功能受損之最重要危險因子(β=20.7, <0.01),同時也是預測病患內皮細胞功能受損之最佳指標(AUC=0.80; 95%CI, 0.65-0.94)。當病患收縮壓高於112 mmHg時,其內皮細胞功能受損之風險將會提高。因此建議類風濕性關節炎病患應監控血壓變化。以預防冠狀動脈疾病的發生。 |
英文摘要 | Whether risk factors exert more-important roles in the development of cardiovascular disease (CVD) with rheumatoid arthritis (RA) is unclear. We investigated traditional and non-traditional risk factors for coronary artery disease (CAD) in relation to endothelial function and ascertained which measure was a better screening strategy for assessing the risk of endothelial dysfunction in patients with RA. Forty-three RA patients were divided into either a normal (n=29) or an abnormal (n=14) endothelial function group based on the measurement of flow-mediated vasodilation. Thirty-three CAD patients were recruited from among cardiology clinic outpatients. Traditional (i.e., smoking, drinking, systolic and diastolic blood pressures, and lipid profiles) and non-traditional risk factors (i. e., inflammatory and immune responses, plasma homocysteine, and deficiency of B vitamins) for CVD were recorded or measured. Systolic blood pressure was significantly higher and was associated with abnormal endothelial function in RA patients (n=20.7, p<0.01) and CAD patients (n=20.6, p<0.01) than RA patients with normal endothelial function after adjusting for various potential confounders. Systolic blood pressure had the highest area under the receiver operating characteristic curve (AUC) (AUC=0.80, 95% confidence interval, 0.65~0.94) for predicting the risk of endothelial dysfunction. The optimal cutoff value for systolic blood pressure to determine a risk of endothelial dysfunction was 112 mmHg. Systolic blood pressure could be a practical tool to screen for risks of endothelial dysfunction in patients with RA. Patients with RA should try to control their blood pressure in order to reduce the risk of CAD. |
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