摘要
目的分析AS患者合并早发冠心病(AS-PCAD)的危险因素。方法回顾北京协和医院1983年1月至2021年7月诊断为AS合并冠心病(CAD)的74例住院患者的临床资料。依据冠心病发病年龄将患者分为PCAD组和NPCAD(非早发冠心病)组。采用t检验、χ^(2)检验对2组数据进行分析, 采用多元Logistic回归分析AS-PCAD的危险因素。结果① 74例患者, PCAD组37例, NPCAD组37例。PCAD组, 男性28例, 女性9例;NPCAD组, 均为男性。2组性别差异有统计学意义(χ^(2)=10.25, P=0.001)。②与NPCAD组相比, PCAD组患者AS发病年龄更小[(23±10)岁和(29±12)岁, t=-2.28, P=0.026], 从AS发病到CAD的病程更短[(25±10)年和(34±13)年, t=-3.00, P=0.004], 血红蛋白水平更低[(122±23)g/L和(132±18)g/L, t=2.10, P=0.039], 贫血发生率更高[38.5%(14/37)和16.2%(6/37), χ^(2)=4.39, P=0.037], CRP升高的发生率更高[65.5%(19/29)和35.5%(11/31), χ^(2)=5.41, P=0.019]。③多元Logisctic回归分析, 青少年型AS[OR值(95%CI)=3.45(1.31, 9.10), P=0.012]及高水平的CRP[OR值(95%CI)=3.68(1.44, 9.40), P=0.006]可能是AS-PCAD的危险因素。结论 AS患者发生PCAD概率较高, 尤其对于青少年型AS、持续炎症状态, 合并贫血的AS患者, 更需要警惕发生PCAD的风险, 早期筛查。
Objective To analyze the risk factors of patients with ankylosing spondylitis(AS)combined with premature coronary atherosclerotic heart disease(PCAD).Methods A total of 74 patients with AS and coronary atherosclerotic heart disease(CAD)in Peking Union Medical College Hospital from January 1983 to July 2021 were enrolled.According to the age of onset of coronary heart disease,the 74 patients were divided into PCAD group and NPCAD(non-premature coronary heart disease)group.T test and Chi square test were used to analyze the data of the two groups,the risk factors for AS-PCAD were analyzed by multivariate Logistic regression.Results①There were 37 cases in the PCAD group and 37 cases in the NPCAD group.In the PCAD group,there were 28 men and 9 women;wherease all were men in the NPCAD group.The difference was statistically significant(χ^(2)=10.25,P=0.001).②Compared with the NPCAD group,the age of AS-PCAD group was younger[(23±10)years vs(29±12)years,t=-2.28,P=0.026],and the course from AS to CAD was shorter[(25±10)years vs(34±13)years,t=-3.00,P=0.004],hemoglobin(Hb)level was lower[(122±23)g/L vs(132±18)g/L,t=2.10,P=0.039],rate of anemia was higher[38.5%(14/37)vs 16.2%(6/37),χ^(2)=4.39,P=0.037].Proportion of increased C-reactive protein(CRP)was higher[65.5%(19/29)vs 35.5%(11/31),χ^(2)=5.41,P=0.019].③Juvenile onset AS(JoAS)[OR(95%CI)=3.45(1.31,9.10),P=0.012]and high levels of CRP[OR(95%CI)=3.68(1.44,9.40),P=0.006]might berisk factors of AS-PCAD by multiple logisctic regression analysis.Conclusion Patients with AS have a higher probability of PCAD,especially in those patients with JoAS,persistent inflammation and anemia.It is necessary to be alert to the risk of PCAD and early screening.
作者
万志红
史群
杨明
王立
李梦涛
曾小峰
张奉春
Wan Zhihong;Shi Qun;Yang Ming;Wang Li;Li Mengtao;Zeng Xiaofeng;Zhang Fengchun(Department of Rheumatology and Clinical Immunology,Chinese Academy of Medical Sciences&Peking Union Medical College,Peking Union Medical College Hospital,National Clinical Research Center for Dermatologic and Immunologic Diseases,Ministry of Science&Technology,State Key Laboratory of Complex Severe and Rare Diseases,Key Laboratory of Rheumatology and Clinical Immunology,Ministry of Education,Beijing 100730,China;Department of Cardiology,Chinese Academy of Medical Sciences&Peking Union Medical College,Peking Union Medical College Hospital,Beijing 100730,China;Department of Rheumatology and Immunology,Huaihe Hospital of Henan University,Kaifeng 475000,China)
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2022年第5期333-337,共5页
Chinese Journal of Rheumatology
关键词
脊柱炎
强直性
早发冠心病
贫血
C反应蛋白
青少年型强直性脊柱炎
Spondylitis,ankylosing
Premature coronary heart disease
Anemia
C-reaction protein
Juvenile onset ankylosing spondylitis
