系统性红斑狼疮合并冠心病的临床特点及治疗现状
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摘要
系统性红斑狼疮(systemic lupus erythematosus,SLE)是一种累及多脏器的自身免疫性炎症性结缔组织病。近20年来,SLE全因病死率在不断下降,心血管疾病已成为SLE患者死亡最主要的原因。SLE合并冠心病(coronary hearty disease,CHD)是心血管事件主要表现形式,往往起病早、病变重、病死率高。积极控制危险因素、药物治疗和血运重建是降低其病死率的有效措施。
Systemic lupus erythematosus(SLE) is an autoimmune inflammatory connective tissue disease involving multiple organs.In the past 20 years,the all-cause mortality of SLE has been decreasing continuously and cardiovascular diseases have become the most important cause of death.Among that,SLE complicate with coronary heart diseases(CHD) is a major form with an earlier onset,more severe coronary lesions,and high mortality rate.Active control of risk factors,drug therapy,and revascularization are effective treatments to reduce the mortality rate.
Systemic lupus erythematosus(SLE) is an autoimmune inflammatory connective tissue disease involving multiple organs.In the past 20 years,the all-cause mortality of SLE has been decreasing continuously and cardiovascular diseases have become the most important cause of death.Among that,SLE complicate with coronary heart diseases(CHD) is a major form with an earlier onset,more severe coronary lesions,and high mortality rate.Active control of risk factors,drug therapy,and revascularization are effective treatments to reduce the mortality rate.
引文
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[2] Croca S,Rahman A.Atherosclerosis in systemic lupus erythematosus[J].Best Pract Res Clin Rheumatol,2017,31(3):364-372.
[3] 蔡莉娜,杨文博,强红丽,等.393例女性冠心病患者的临床特征及预后探讨[J].临床心血管病杂志,2018,34(9):876-879.
[4] 孟树萍,胡延磊,丁付燕,等.冠状动脉病变与颈动脉粥样硬化及脑梗死的关系[J].临床心血管病杂志,2018,34(10):987-989.
[5] Tselios K,Urowitz MB.Cardiovascular and pulmonary manifestations of systemic lupus erythematosus[J].Curr Rheumatol Rev,2017,13(3):206-218.
[6] Bartels CM,Buhr KA,Goldberg JW,et al.Mortality and cardiovascular burden of systemic lupus erythematosus in a US population-based cohort[J].J Rheumatol,2014,41(4):680-687.
[7] Avina-Zubieta JA,To F,Vostretsova K,et al.Risk of myocardial infarction and stroke in newly diagnosed systemic lupus erythematosus:A general population-based study[J].Arthritis Care Res,2017,69(6):849-856.
[8] Wigren M,Nilsson J,Kaplan m J.Pathogenic immunity in systemic lupus erythematosus and atherosclerosis:common mechanisms and possible targets for intervention[J].J Int Med,2015,278(5):494-506.
[9] Ugarte A,Danza A,Ruiz-Irastorza G.Glucocorticoids and antimalarials in systemic lupus erythematosus:an update and future directions[J].Curr Opin Rheumatol,2018,30(5):482-489.
[10] Al Sawah S,Zhang X,Zhu B,et al.Effect of corticosteroid use by dose on the risk of developing organ damage over time in systemic lupus erythematosus-the Hopkins Lupus Cohort[J].Lupus Sci Med,2015,2(1):e000066.
[11] Ruiz-Arruza I,Ugarte A,Cabezas-Rodriguez I,et al.Glucocorticoids and irreversible damage in patients with systemic lupus erythematosus[J].Rheumatology,2014,53(8):1470-1476.
[12] Mok CC,Tse SM,Chan KL,et al.Effect of immunosuppressive therapies on survival of systemic lupus erythematosus:a propensity score analysis of a longitudinal cohort[J].Lupus,2018,27(5):722-727.
[13] Ruiz-Arruza I,Lozano J,Cabezas-Rodriguez I,et al.Restrictive use of oral glucocorticoids in systemic lupus erythematosus and prevention of damage without worsening long-term disease control:An observational study[J].Arthritis Care Res (Hoboken),2018,70(4):582-591.
[14] Spinelli FR,Moscarelli E,Ceccarelli F,et al.Treating lupus patients with antimalarials:analysis of safety profile in a single-center cohort[J].Lupus,2018,27(10):1616-1623.
[15] Szabo MZ,Szodoray P,Kiss E.Dyslipidemia in systemic lupus erythematosus[J].Immunol Res,2017,65(2):543-550.
[16] Ulivieri C,Baldari CT.Statins:from cholesterol-lowering drugs to novel immunomodulators for the treatment of Th17-mediated autoimmune diseases[J].Pharmacol Res,2014,88:41-52.
[17] Jorge AM,Lu N,Keller SF,et al.The effect of statin use on mortality in systemic autoimmune rheumatic diseases[J].J Rheumatol,2018,45(12):1689-1695.
[18] Watanabe T,Oku K,Amengual O,et al.Effects of statins on thrombosis development in patients with systemic lupus erythematosus and antiphospholipid antibodies[J].Lupus,2018,27(2):225-234.
[19] Yousef Yengej FA,Limper M,Leavis HL.Statins for prevention of cardiovascular disease in systemic lupus erythematosus[J].Neth J Med,2017,75(3):99-105.
[20] Iudici M,Fasano S,Gabriele Falcone L,et al.Low-dose aspirin as primary prophylaxis for cardiovascular events in systemic lupus erythematosus:a long-term retrospective cohort study[J].Rheumatology,2016,55(9):1623-1630.
[21] Fasano S,Pierro L,Pantano I,et al.Longterm hydroxychloroquine therapy and low-dose aspirin may have an additive effectiveness in the primary prevention of cardiovascular events in patients with systemic lupus erythematosus[J].J Rheumatol,2017,44(7):1032-1038.
[22] Benvenuti F,Gatto M,Larosa M,et al.Cardiovascular risk factors,burden of disease and preventive strategies in patients with systemic lupus erythematosus:a literature review[J].Expert Opin Drug Saf,2015,14(9):1373-1385.
[23] Bundhun PK,Boodhoo KD,Long MY,et al.Impact of antiphospholipid syndrome and/or systemic lupus erythematosus on the long-term adverse cardiovascular outcomes in patients after percutaneous coronary intervention:a systematic review and meta-analysis[J].Medicine (Baltimore),2016,95(12):e3200.
[24] Lai CH,Lai WW,Chiou MJ,et al.Outcomes of percutaneous coronary intervention in patients with rheumatoid arthritis and systemic lupus erythematosus:an 11-year nationwide cohort study[J].Ann Rheum Dis,2016,75(7):1350-1356.
[25] Lai CH,Lai WW,Chiou MJ,et al.Outcomes of coronary artery bypass grafting in patients with inflammatory rheumatic diseases:an 11-year nationwide cohort study[J].J Thorac Cardiovasc Surg,2015,149(3):859-866.
[2] Croca S,Rahman A.Atherosclerosis in systemic lupus erythematosus[J].Best Pract Res Clin Rheumatol,2017,31(3):364-372.
[3] 蔡莉娜,杨文博,强红丽,等.393例女性冠心病患者的临床特征及预后探讨[J].临床心血管病杂志,2018,34(9):876-879.
[4] 孟树萍,胡延磊,丁付燕,等.冠状动脉病变与颈动脉粥样硬化及脑梗死的关系[J].临床心血管病杂志,2018,34(10):987-989.
[5] Tselios K,Urowitz MB.Cardiovascular and pulmonary manifestations of systemic lupus erythematosus[J].Curr Rheumatol Rev,2017,13(3):206-218.
[6] Bartels CM,Buhr KA,Goldberg JW,et al.Mortality and cardiovascular burden of systemic lupus erythematosus in a US population-based cohort[J].J Rheumatol,2014,41(4):680-687.
[7] Avina-Zubieta JA,To F,Vostretsova K,et al.Risk of myocardial infarction and stroke in newly diagnosed systemic lupus erythematosus:A general population-based study[J].Arthritis Care Res,2017,69(6):849-856.
[8] Wigren M,Nilsson J,Kaplan m J.Pathogenic immunity in systemic lupus erythematosus and atherosclerosis:common mechanisms and possible targets for intervention[J].J Int Med,2015,278(5):494-506.
[9] Ugarte A,Danza A,Ruiz-Irastorza G.Glucocorticoids and antimalarials in systemic lupus erythematosus:an update and future directions[J].Curr Opin Rheumatol,2018,30(5):482-489.
[10] Al Sawah S,Zhang X,Zhu B,et al.Effect of corticosteroid use by dose on the risk of developing organ damage over time in systemic lupus erythematosus-the Hopkins Lupus Cohort[J].Lupus Sci Med,2015,2(1):e000066.
[11] Ruiz-Arruza I,Ugarte A,Cabezas-Rodriguez I,et al.Glucocorticoids and irreversible damage in patients with systemic lupus erythematosus[J].Rheumatology,2014,53(8):1470-1476.
[12] Mok CC,Tse SM,Chan KL,et al.Effect of immunosuppressive therapies on survival of systemic lupus erythematosus:a propensity score analysis of a longitudinal cohort[J].Lupus,2018,27(5):722-727.
[13] Ruiz-Arruza I,Lozano J,Cabezas-Rodriguez I,et al.Restrictive use of oral glucocorticoids in systemic lupus erythematosus and prevention of damage without worsening long-term disease control:An observational study[J].Arthritis Care Res (Hoboken),2018,70(4):582-591.
[14] Spinelli FR,Moscarelli E,Ceccarelli F,et al.Treating lupus patients with antimalarials:analysis of safety profile in a single-center cohort[J].Lupus,2018,27(10):1616-1623.
[15] Szabo MZ,Szodoray P,Kiss E.Dyslipidemia in systemic lupus erythematosus[J].Immunol Res,2017,65(2):543-550.
[16] Ulivieri C,Baldari CT.Statins:from cholesterol-lowering drugs to novel immunomodulators for the treatment of Th17-mediated autoimmune diseases[J].Pharmacol Res,2014,88:41-52.
[17] Jorge AM,Lu N,Keller SF,et al.The effect of statin use on mortality in systemic autoimmune rheumatic diseases[J].J Rheumatol,2018,45(12):1689-1695.
[18] Watanabe T,Oku K,Amengual O,et al.Effects of statins on thrombosis development in patients with systemic lupus erythematosus and antiphospholipid antibodies[J].Lupus,2018,27(2):225-234.
[19] Yousef Yengej FA,Limper M,Leavis HL.Statins for prevention of cardiovascular disease in systemic lupus erythematosus[J].Neth J Med,2017,75(3):99-105.
[20] Iudici M,Fasano S,Gabriele Falcone L,et al.Low-dose aspirin as primary prophylaxis for cardiovascular events in systemic lupus erythematosus:a long-term retrospective cohort study[J].Rheumatology,2016,55(9):1623-1630.
[21] Fasano S,Pierro L,Pantano I,et al.Longterm hydroxychloroquine therapy and low-dose aspirin may have an additive effectiveness in the primary prevention of cardiovascular events in patients with systemic lupus erythematosus[J].J Rheumatol,2017,44(7):1032-1038.
[22] Benvenuti F,Gatto M,Larosa M,et al.Cardiovascular risk factors,burden of disease and preventive strategies in patients with systemic lupus erythematosus:a literature review[J].Expert Opin Drug Saf,2015,14(9):1373-1385.
[23] Bundhun PK,Boodhoo KD,Long MY,et al.Impact of antiphospholipid syndrome and/or systemic lupus erythematosus on the long-term adverse cardiovascular outcomes in patients after percutaneous coronary intervention:a systematic review and meta-analysis[J].Medicine (Baltimore),2016,95(12):e3200.
[24] Lai CH,Lai WW,Chiou MJ,et al.Outcomes of percutaneous coronary intervention in patients with rheumatoid arthritis and systemic lupus erythematosus:an 11-year nationwide cohort study[J].Ann Rheum Dis,2016,75(7):1350-1356.
[25] Lai CH,Lai WW,Chiou MJ,et al.Outcomes of coronary artery bypass grafting in patients with inflammatory rheumatic diseases:an 11-year nationwide cohort study[J].J Thorac Cardiovasc Surg,2015,149(3):859-866.