Сердечно-сосудистые осложнения при системной красной волчанке: механизмы ускоренного развития атеросклероза, диагностика, возможности коррекции

Автор: Аршинов А.В., Левшин Н.Ю., Маслова И.Г.

Журнал: Научно-практическая ревматология @journal-rsp

Статья в выпуске: 3 т.55, 2017 года.

Бесплатный доступ

Атеросклероз и его осложнения - главная причина поздней смертности среди пациентов с системной красной волчанкой (СКВ). СКВ и ишемическую болезнь сердца (ИБС) объединяют общие патофизиологические механизмы, связанные с системным и хроническим воспалением. В то же время традиционные факторы риска, например артериальная гипертензия, пожилой возраст, курение, гиперхолестеринемия, ожирение и мужской пол, не могут полностью объяснить механизм ускоренного развития атеросклероза у пациентов с СКВ. Наличие специфических факторов риска, таких как длительность течения, применение глюкокортикоидов, присутствие аутоантител к двуспиральной (нативной) ДНК и наличие антифосфолипидных антител, создают условия для ускорения развития атеросклероза в данной группе больных. Имеющиеся факты указывают на то, что ревматолог может понизить риск развития сердечно-сосудистых заболеваний (ССЗ), контролируя активность СКВ. Также должна проводиться коррекция традиционных факторов риска ССЗ, начиная с отказа от курения, контроля массы тела и артериального давления. Необходимо учитывать роль проводимой противовоспалительной терапии, в частности позитивное влияние таких препаратов, как противомалярийные средства и микофенолата мофетил, и прогностически неблагоприятный эффект длительного применения глюкокортикоидов. Дальнейшие исследования должны помочь разработать эффективные шкалы риска развития, конкретные терапевтические программы профилактики и лечения ССЗ у больных СКВ.

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Системная красная волчанка, атеросклероз, нетрадиционные сердечно-сосудистые факторы риска, лечение сердечно-сосудистых событий

Короткий адрес: https://sciup.org/14945824

IDR: 14945824 | DOI: 10.14412/1995-4484-2017-304-310

Список литературы Сердечно-сосудистые осложнения при системной красной волчанке: механизмы ускоренного развития атеросклероза, диагностика, возможности коррекции

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