| PART Ⅰ Evaluation of left atrial function in patients with rheumatoid arthritis by echocardiographyObjective: Two dimensional speckle tracking imaging(2D-STI)and real-time threedimensional echocardiography(RT-3DE)were used to evaluate left atrial function in patients with rheumatoid arthritis.Methods: A total of 30 RA patients and 30 normal controls were collected in this study.2D-STI technology was used to measure the strain(LASs,LASe and LASa)and the strain rate(LASRs,LASRe and LASRa)of the left atrial during the systolic,early diastolic and late diastolic stages.The maximum and minimum left atrial volumes(LAVmax,LAVmin)and left atrial presystolic volume(LAVpre)were obtained by RT-3DE technology.According to the formula,parameters were obtained: Total LASV,Total LAEF,Passive LASV,Passive LAEF,Active LASV and Active LAEF.Finally,the correlation of the left atrial strain and the strain rate with Total LAEF,Passive LAEF and Active LAEF was analyzed by using the Pearson linear correlation method.Results: LASs,LASRs,LASe,LASRe,Total LAEF,Passive LAEF and Passive LA SV of the RA group were significantly lower than those in normal group(P<0.05).LASs was positively correlated with Total LAEF(P<0.05);LASe was positively correlated with Passive LAEF(P<0.05);LASa was positively correlated with Active LAEF(P<0.05);while LASRs was negatively correlated with Total LAEF(P<0.05).Conclusion: The LA function is significantly impaired in RA patients.In addition,it is more easier and convenient to reflect the impaired LA function on account of combining 2D-STI technology with 3D-volume technology.PART Ⅱ Objective to establish a nomogram prediction model for the risk of coronary heart disease in patients with rheumatoid arthritisObjective: The probing of the establishment of a risk model for rheumatoid arthritis(RA)with coronary heart disease(CHD).Methods: The clinical data of 315 RA patients admitted to the Department of Rheumatology and immunology of Changzhou Second People’s Hospital from March 2012 to September 2018 were retrospectively analyzed.The patients were separated into an RA with CHD group and an RA group,respectively.The general data,laboratory indexes and examination indexes were compared between the two groups,and the independent predictive factors for RA patients in risk of CHD were screened by single factor analysis and binary multivariate logistic regression analysis.The independent factors were combined to construct the nomogram prediction model of CHD in RA patients,and the prediction and discrimination of the model were verified internally.Results: Logistic regression analysis showed that uric acid(UA,OR=1.006,95% CI:1.001~1.011),carotid-femoral pulse wave velocity(cf PWV,OR=1.437,95%CI:1.032~2.000),Crouse plaque score at the cervical artery(OR=1.277,95%CI:1.027~1.586),electro cardio graphic changes(OR=2.623,95%CI:1.074~6.405),the course of RA disease(OR=1.142,95%CI:1.025~1.272),glycosylated hemoglobin(Hb A1 c,OR=1.588,95%CI:1.020~2.473)and hypertension(OR=2.575,95%CI:1.073~6.175)were independent predictive factors of RA with CHD(P<0.05).Establish a nomogram model based on these independent factors,and verify it through the Bootstrap internal verification method.The C-index index was 0.89(0.825~0.903).Conclusion: The nomogram prediction model exhibits good predictability,high accuracy and discrimination against CHD in patients with RA;and the model is noninvasive and economical,which can provide a reference for clinical prognosis and treatment. |
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