Mối liên quan giữa viêm khớp dạng thấp với mảng xơ vữa động mạch cảnh ở người cao tuổi=Association between rheumatoid arthritis and carotid atherosclerotic plaques in the elderly

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Tác giả: Thanh Ngọc Cao, Ngọc Sơn Đặng, Thanh Vy Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.288-294

Bộ sưu tập: Báo, Tạp chí

ID: 243600

Thêm vào giỏ

Khảo sát mối liên quan giữa viêm khớp dạng thấp (VKDT) và các đặc điểm lâm sàng, cận lâm sàng của VKDT với mảng xơ vữa động mạch cảnh ở người cao tuổi. Đối tượng và phương pháp: Nghiên cứu cắt ngang thực hiện trên 130 bệnh nhân cao tuổi (≥ 60 tuổi)
bao gồm 65 bệnh nhân mắc VKDT, 65 bệnh nhân không mắc VKDT đến khám tại phòng khám Nội cơ xương khớp và phòng khám Lão khoa, Bệnh viện Đại học Y Dược Thành phố Hồ Chí Minh từ tháng 08/2022 đến tháng 05/2023. Bệnh nhân được ghi thông tin nhân khẩu học, thăm khám, xét nghiệm máu và siêu âm doppler động mạch cảnh đánh giá mảng xơ vữa. Kết quả: VKDT có mối liên quan độc lập với mảng xơ vữa động mạch cảnh (OR = 5,059
p = 0,002). Ở bệnh nhân VKDT cao tuổi, nồng độ LDL-c (OR = 1,022
p = 0,020), thời gian mắc VKDT (OR = 1,331
p = 0,046), kháng thể anti-CCP (OR = 5,400
p = 0,032) là những yếu tố liên quan với sự hiện diện mảng xơ vữa động mạch cảnh. Phương trình tiên đoán khả năng có mảng xơ vữa động mạch cảnh ở bệnh nhân VKDT cao tuổi là P = 1/(1+ elogit( Mảng xơ vữa ĐMC)). Trong đó: Logit (Mảng xơ vữa ĐMC) = -3,921 + 0,021 x Nồng độ LDL-c máu (mg/dl) + 0,286 x Thời gian mắc VKDT (năm) + 1,686 x Anti-CCP dương tính. Kết luận: Ở người cao tuổi, VKDT có liên quan độc lập đến sự xuất hiện của mảng xơ vữa động mạch cảnh. Các yếu tố như nồng độ LDL-c, thời gian mắc VKDT và sự hiện diện của kháng thể anti-CCP dương tính liên quan đến sự hiện diện mảng xơ vữa động mạch cảnh ở bệnh nhân VKDT cao tuổi.To investigate the association between rheumatoid arthritis (RA) and clinical and subclinical characteristics of RA with carotid atherosclerotic plaques in the elderly. Methods: A cross-sectional study was conducted on 130 elderly patients (≥ 60 years old), including 65 RA patients and 65 non-RA patients, who visited the Rheumatology and Geriatrics Clinic at the University Medical Center Ho Chi Minh City from August 2022 to May 2023. Patients were documented for demographic information, physical examination, blood tests, and carotid ultrasound to record atherosclerotic plaques. Results: RA was independently associated with carotid atherosclerotic plaques with an OR of 5.059
p = 0.002. In elderly RA patients, LDL-c levels (OR = 1.022
p = 0.020), RA duration (OR = 1.331
p = 0.046), and positive anti-CCP antibodies (OR = 5.400
p = 0.032) were associated with carotid atherosclerotic plaques. The prediction equation for the presence of carotid atherosclerotic plaques in elderly RA patients is P = 1/ (1+ e-logit (Carotid plaques)) where Logit (Carotid plaques) = -3.921 + 0.021 x LDLc level (mg/dL) + 0.286 x RA duration (years) + 1.686 x positive anti-CCP antibodies. Conclusion: In the elderly, RA is independently associated with the presence of carotid atherosclerotic plaques. Additionally, factors including LDL-c levels, RA duration, and the presence of positive anti-CCP antibodies are associated with carotid atherosclerotic plaques in elderly RA patients.

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