| Objective:Rheumatoid arthritis(RA)is a systemic autoimmune diseases which can destroy peripheral joints.In addition to the joints,there are one or more tissues or organs are involved in,such as heart? lungs?kidneys and other important internal organizations.Study showed that the probability of cardiovascular events or diseases caused by RA is similar to that by diabetes;Psychogenic death accounted for 42% in the death of RA.Because of the lack of specific biological marker in the decision of patients with RA,The prevention measures in the treatment of RA patients with cardiovascular diseases should be investigated.The purpose of this paper is to study the differences between RA-CVD and RA in several indexs,such as Clinical Features,DAS28,RF and anti-CCP,MIF,TNF-?,ET-1,MLT,OSCAR etc;To explore the serum biomarkers and clinical features of RA-CVD.We also preliminarily observed the short term efficacy of routine RA combined with integrative medicine treatment on RA-CVD and its effect on serum biomarkers.Methods:1 Selecting 58 patients with RA as the objects,according to the results of myocardial repolarization Twelve-lead ECG and Ultrasonic Cardiogram,to divide into RA&CVD and RA group.There were 27 cases healthy for control group.2 Several methods,such as ELISA,Automatic biochemical analyzer etc,were used to detect ESR,CRP,rheumatic factor,cyclic citrulline polypeptide in RA and RA-CVD;Evaluating and calculating indicators: DAS28 etc,counting the differences between RA and RA-CVD in several indicators.3 Using ELISA,MIF? TNF-?? ET-1? MLT ?OSCAR were detected and compared in RA,RA-CVD and control group,4 17 cases of RA-CVD were selected,normal integrative medicine were used,Observed after 2 weeks of treatment,We detected changes in clinical parameters and peripheral MIF,TNF-?,ET-1,MLT,OSCAR levelReaults:1 The level of CRP,ESR,RF,and DAS28 of the group RA+CVD were higher than the of group RA(P > 0.05).2 The level of anti-CCP of the group RA+CVD was significant higher than the of group RA(P<0.05).3 The level of ET-1 of the group RA+CVD and RA were significant higher than the of group NC(P<0.05),but there was no significantly different between the two group.The level of TNF-?of the group RA was higher than the of group RA+CVD(P>0.05),significant higher than the of group NC(P<0.05).The level of MIF of the group RA+CVD and RA were higher than the of group NC.The level of OSCAR of the group RA+CVD and RA were lower than the of group NC(P>0.05).The level of MLT of the group RA+CVD was significant lower than the of group RA and NC(P <0.05).4 After 2 weeks of integrative medicine treatment,RA clinical conditions were improved in RA+CVD,the levels of ET-1 and TNF-? were significant lower than before(P<0.05),The level of MIF?MLT and OSCAR were lower than before(P>0.05).5 After 2 weeks of integrative medicine treatment,the levels of ESR and CRP of the group RA+CVD wsa significant lower than before(P<0.05),the levels of UA and TG of the group RA+CVD wsa lower than before(P>0.05)Conclusions:1 Anti-CCP antibodies must be associtated with risks of cardiovascular disease in RA.2 The level of MLT may play a negative regulatory role in cardiovascular damage in patients with RA.The level of ET-1?TNF-??MIF and the resk of the cardiovascular damages in RA has certain correlation.The level of OSCAR may play a negative regulatory role in RA.3 Integrative Medicine program may improve endothelial function by reducing circulating ET-1 levels,it also play an important role in the prevention of RA+CVD by Anti-inflammatory mechanism. |
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