| Objective: 1.TO explore the occurrence of atherosclerosis,abnormal Electrocardiogram and valvular heart disease in patients with rheumatoid arthritis(RA)by Electrocardiogram,neck vascular ultrasound and echocardiography.2.To evaluate the serum Homocysteine(Hcy),Paraoxonase1(PON1)and clinical indicators in RA patients and analysis whether PON1,Hcy,inflammatory factors play the role in RA patients complicated with atherosclerosis or not.Methods:60 RA patients and 60 healthy subjects with same demographic characteristics were enrolled into the study.Homocysteine and Paraoxonase-1 were measured by ELISA.Electrocardiogram,neck vascular ultrasound and echocardiography were conducted to all the subject.The clinic date of RA patients were collected.The results were analyzed by using SPSS19.0 pakage.Results:1.The abnormal rate of electrocardiogram in RA patients was 20%(12/60 cases),they were ST-Tchanges,condition block,atrial premature beats,abnormal Q-wave,QT interval prolongation and in the healthy control group the abnormal rate of electrocardiogram was 16.6%(10/60 cases),There was no statistically significant difference between them(c2=0.223,P>0.05)?2.The abnormal rate of echocardiography in RA patients was 36.67%(22/60 cases).The abnormality includes valvular regurgitation,valve insufficiency,diastolic dysfunction.In the healthy control group the abnormal rate of echocardiography was23.33%(14/60 cases).There was no significant statistical difference between this two groups(c2=2.54,P>0.05).3.The rate of carotid atherosclerosis in RA patients was 38.33%(23/60 cases),including carotid early-onset atherosclerosis 13 cases(1.0mm?IMT < 1.2mm),carotid atherosclerotic plaque formation 10 cases(IMT?1.2mm);while in the healthy control group the rate of atherosclerosis was 16.67%(10/60 cases),there was significant statistical difference between RA patients and healthy control group(c2=7.046,P <0.01).4.IMT value in RA patients were significantly higher than that in the healthy control subjects [(0.91±0.29)mm vs(0.71±0.25)mm,P <0.01].5.In the group of RA patients with atherosclerosis,PON1 level was lower than that in the group of patients with early-onset atherosclerosis and the group without atherosclerosis and the healthy control group [(96.65±32.84)umol/L vs(140.07±28.05)umol/L vs(152.52±35.39)umol/L vs(152.13±27.24)umol/L,F=10.25,P <0.01 ].No statistically difference can be found to the serum levels of PON1 among the group with early-onset atherosclerosis,the group without atherosclerosis and the healthy control group(P>0.05).6.In the group of RA patients with atherosclerosis,with early-onset atherosclerosis,Hcy level was higher than that in the group without atherosclerosis and the healthy control group.[(15.60±3.73)umol/L vs(15.13±3.39)umol/L vs(11.92±3.65)umol/L vs(9.09±3.70)umol/L,F=16.97,P <0.01].The difference of serum levels of Hcy between the group with atherosclerosis and the group with early-onset atherosclerosis was not statistically significant(P>0.05).No statistically difference can be found to the serum levels of Hcy between the group without atherosclerosis and the healthy control group(P>0.05).7.In the group of RA patients with atherosclerosis,ESR level was higher than that in the group with early-onset atherosclerosis and the group without atherosclerosis.[(89.02±26.23)mm/h vs(80.56±23.61)mm/h vs 60.92±30.01)mm/h,F=5.11 P <0.01],No statistically difference can be found to the serum levels of ESR between the group with early-onset atherosclerosis and the group without atherosclerosis(P>0.05).8.In the group of RA patients with atherosclerosis,CRP level was higher than that in the group with early-onset atherosclerosis and the group without atherosclerosis[(57.54±24.02)mg/L vs(43.37±21.07)mg/L vs(36.19±16.61)mg/L F=5.1,P <0.01].No statistically difference can be found to the serum levels of CRP between the group with early-onset atherosclerosis and the group without atherosclerosis.(P>0.05).9.Disease duration,RF,ACCP,DAS28 among the group with atherosclerosis,the group with early-onset atherosclerosis and the group without atherosclerosis,the difference were not statistically significant(P>0.05).10.In the RA patients with therosclerosis,the level of IMT was statistically positively correlated with Hcy(r=0.568,P<0.01),CRP(r=0.435,P<0.05).No correlation was observed between IMT,PON1,and ESR.Conclusion: 1.Compared with healthy controls,there was a higher prevalence of therosclerosis in RA patients.2.In the group of RA patients with therosclerosis,serum PON1 level was significantly lower than that in the group of RA patients without therosclerosis and the healthy control group,serum HCY,ESR,CRP level was significantly higher than that in the group of RA patients without therosclerosis and the healthy control group.IMT might be related with the serum level of HCY(r=0.568,P<0.01),CRP(r=0.435,P<0.05).PON1,Hcy,inflammatory factors may play an important role in RA patients with therosclerosis. |
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