Характериcтика лабораторних показникiв за ревматоїдного артриту окремо та у поєднанні з ішемічною хворобою серця

Abstract

The purpose of the study was to analyze the indicators of the lipid spectrum of blood in patients with rheumatoid arthritis individually and in combination with coronary heart disease. Materials and methods. 91 patients with rheumatoid arthritis were examined, which were divided into 2 subgroups – patients with rheumatoid arthritis without concomitant pathology of the cardiovascular system and patients with rheumatoid arthritis with coronary heart disease. The groups were matched in age and gender. The control group consisted of 31 patients with coronary heart disease. When entering the hospital a detailed clinical and biochemical examination with the determination of the pain scale, the number of painful and swollen joints, the duration of the morning stiffness, functional condition, lipid profile of blood was carried out. Results and discussion. In the study of the lipid spectrum of blood, a probable difference between the number of patients with signs of previously undiagnosed hyperlipidemia among patients with rheumatoid arthritis and rheumatoid arthritis with coronary heart disease was detected. At the same time, they observed dependence on the duration of the disease and the age of patients. The most significant changes were detected in the analysis of levels of total cholesterol, high density lipoprotein and low density lipoprotein, atherogenic coefficient. The indicators of blood triglycerides content had only a trend towards an increase in the subgroup of patients with combined nosology, which was not statistically confirmed. The incidence of hypercholesterolemia was 43.4% in the population of patients with rheumatoid arthritis, and 57.6% in patients with rheumatoid arthritis with coronary heart disease. Low density lipoprotein levels exceeded 3.0 mmol/l in 62.7% of rheumatoid arthritis patients and in 81.2% of patients with rheumatoid arthritis with coronary heart disease. The quantitative content of high density lipoprotein less than 1.0 mmol/l was found in 22.9% of patients with rheumatoid arthritis and in 39.6% of patients with rheumatoid arthritis with coronary heart disease. Conclusion. Among patients with rheumatoid arthritis without concomitant cardiovascular disease, and for the combination of rheumatoid arthritis with coronary heart disease, there is a high percentage of patients with hyperlipidemias. Patients with rheumatoid arthritis with concomitant coronary heart disease have reliably higher rates of total cholesterol and low density lipoprotein in the blood, and a reliably lower high density lipoprotein content. The growth of atherogenic coefficient above 3.5 in young and middle-aged patients for the combination of rheumatoid arthritis and coronary heart disease indicates a higher risk of developing cardiovascular disease and their complications in these age groups