Karakteristike aterosklerotskog plaka i debljina intima-medija kompleksa karotidnih arterija kod bolesnika sa reumatoidnim artritisom
Sažetak
Uvod/Cilj. Reumatoidni artritis (RA) predstavlja nezavisni faktor rizika od nastanka kardiovaskularnih (KV) oboljenja (KVO). Rano otkrivanje aterosklerotskih prom-ena je ključno u prevenciji KV događaja. Povećanje debljine kompleksa intima-medija (DKIM) na karotidnim arterijama smatra se senzitivnim markerom rane, subklin-ičke ateroskleroze. Cilj našeg ispitivanja bio je da procen-imo DKIM, broj i tip karotidnih plakova (KP), težinu ste-noze karotidnih arterija kod bolesnika sa RA kao i pov-ezanost navedenih parametara sa dužinom trajanja i ak-tivnosti bolesti. Metode. U studiju je bilo uključeno 92 učesnika, od kojih je njih 58 imalo RA, a preostalih 34 bile su zdrave osobe (kontrolna grupa). Kod bolesnika sa RA procena aktivnosti bolesti vršena je na osnovu kliničkog pregleda i laboratorijskih analiza. Svim ispitanicima urađen je kolor Dopler ultrazvučni pregled karotidnih arterija kojim su procenjivani DKIM, broj i tip KP, kao i težina stenoznih lezija. Rezultati. Bolesnici sa RA imali su statis-tički značajno veće vrednosti DKIM u odnosu na kontrol-nu grupu (0,8 ± 0,2 mm vs. 0,7 ± 0,2 mm; p < 0,01). KP registrovani su kod 34 od ukupno 58 bolesnika iz RA grupe (58,6%) i kod 4 od ukupno 34 (11,8%) osoba iz kontrolne grupe (p < 0,001). Broj KP po ispitaniku bio je statistički značajno veći kod bolesnika sa RA u odnosu na kontrolnu grupu (1,4 ± 0,9 vs. 0,2 ± 0,4; p < 0.001). DKIM, prisustvo i broj KP kao i težina stenoza karotidnih arterija nisu se statistički razlikovali u odnosu na aktivnost bolesti. Postojala je statistički značajna korelacija dužine trajanja RA i procenata stenozirajućih promena (r = 0,320, p = 0,034) Zaključak. Kod bolesnika sa RA detektovana je značajno veća vrednost DKIM, kao i veća zastupljenost i broj KP po ispitaniku. Postojala je pozitivna korelacija između dužine trajanja RA i težine stenozirajućih lezija. Ova studija pokazala je da RA predstavlja nezavisni faktor rizika za povećanje DKIM i nastanak subkliničke ateroskleroze.
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