非甾体抗炎药治疗可显著增加小肠损伤的风险-上海强直医院

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非甾体抗炎药治疗可显著增加小肠损伤的风险

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作者Avram C, et al

翻译北医三院刘蕊（maryllr@163.com）

摘要 : 心血管风险是强直性脊柱炎患者发病率和死亡率增加的重要因素。本研究的目的是评估强直性脊柱炎患者疾病活动性及功能障碍同动脉硬化之间的关系。本研究纳入 24例强直性脊柱炎患者（平均年龄45.8±11.7岁，病程11.1±5.1年）和24例性别和年龄相匹配的健康对照者。记录强直性脊柱炎患者的临床，生物学和功能状态的数据。动脉硬化是通过测量脉搏波传导速度（PWV）评估，并用压平眼压测量法进行脉搏波分析（PWA）。我们发现，强直性脊柱炎患者和健康对照组之间PWV（P = 0.047），主动脉增强压力-AP（P = 0.028），增强指数的AIx（P = 0.038）和主动脉增强指数校正的心脏速率 - AIx75（p = 0.011）存在显著差异。 PWV和AIx75与疾病功能评分，BASFI均显著相关（P = 0.012，R = 0.504，P = 0.041，R = 0.421）。主动脉AP和增强指数（AIX和AIx75）均与ASDAS评分相关（P = 0.028，R = 0.448，P = 0.005，R = 0.549，P = 0.025，R = 0.455）。我们的研究表明，强直性脊柱炎患者较年龄匹配的对照组动脉硬度较高，从而导致心血管疾病的危险增加。我们发现，动脉僵硬度与疾病活动性和功能障碍正相关。即使没有传统心血管危险因素，也应对慢性脊柱关节病患者进行动脉硬化程度的筛选，以从初级预防措施中受益。

附全文: Abstract Cardiovascular risk is an important factor for increased morbidity and mortality in patients with ankylosing spondylitis. The aim of this study is to assess arterial stiffness in relation to the disease activity and functional limitation in patients with ankylosing spondylitis. Twenty-four patients (mean age 45.8?±?11.7 years) suffering of ankylosing spondylitis (disease duration 11.1?±?5.1 years) and 24 gender and age-matched healthy controls were included in the study. Clinical, biological, and functional status of ankylosing spondylitis patients was recorded. Arterial stiffness was assessed by measuring pulse wave velocity (PWV) and pulse wave analysis (PWA) was performed using applanation tonometry. We found significant differences between ankylosing spondylitis patients and healthy controls in regard to PWV (p?=?0.047), aortic augmentation pressure-AP (p?=?0.028), augmentation index-AIx (p?=?0.038) and aortic augmentation index adjusted for heart rate-AIx75 (p?=?0.011). PWV and AIx75 were significantly associated with the disease functioning score-BASFI (p?=?0.012, r?=?0.504; p?=?0.041, r?=?0.421). Aortic AP and augmentation indexes (AIx and AIx75) were all associated to ASDAS score (p?=?0.028, r?=?0.448; p?=?0.005, r?=?0.549; p?=?0.025, r?=?0.455). Our study showed that ankylosing spondylitis patients have a higher arterial stiffness than the age-matched controls, leading to an increased cardiovascular risk. We found that arterial stiffness is positively associated with disease activity and functional impairment. Chronic spondiloarthropaties should be screened for arterial stiffness, even in the absence of traditional cardiovascular risk factors, in order to benefit from primary prevention measures.

引自：Avram C1, Dr?goi RG2, Popoviciu H3,et al. Association between arterial stiffness, disease activity and functional impairment in ankylosing spondylitis patients: a cross-sectional study.Clin Rheumatol. 2016 Aug;35(8):2017-22. doi: 10.1007/s10067-016-3297-7. Epub 2016 May 12.

强直性脊柱炎诊疗新进展

强直性脊柱炎久治不愈与其本身病程复杂性有关，深层原因则是较长一段时间来，我国医疗政策对该病种的师资力量投入不足导致研究进展止步不前。如何改变这一现状？

专病专治，以“专”带“全”，国家医改近来做出多项举措，弥补综合性医院对慢性病投入不足的缺失。在国际化都市上海设立一座强直性脊柱炎专病专治医院，简称“上海强直医院”，受到原国家卫生部副部长孙隆椿的高度评价。