Ilowite N T
Children's Hospital, Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, New York 11040, USA.
J Rheumatol Suppl. 2000 Apr;58:15-9.
Premature atherosclerosis is a recognized complication of systemic lupus erythematosus (SLE). Since life expectancy in SLE is improving, premature atherosclerosis is emerging as an ever more important clinical issue. Atherosclerosis begins in the pediatric age group, and interventions directed at prevention should begin in childhood as well. Possible etiologies include dyslipoproteinemia (DL) from the underlying chronic inflammatory disease or from corticosteroid therapy, hypercoagulation due to antiphospholipid antibodies or nephrotic syndrome, vasculitis, and hypertension. A relationship between DL and presence of anticardiolipin antibodies (aCL) has been reported. Dietary therapy is helpful, but many patients continue to have significant DL after both dietary modification and fish oil supplementation. Lipid lowering drugs may be indicated in this subgroup. Potential mechanisms of the DL are discussed. Other strategies to prevent atherosclerosis and its complications are reviewed.
早发性动脉粥样硬化是系统性红斑狼疮（SLE）公认的并发症。由于SLE患者的预期寿命正在提高，早发性动脉粥样硬化正日益成为一个更为重要的临床问题。动脉粥样硬化始于儿童年龄组，预防干预也应在儿童期开始。可能的病因包括潜在慢性炎症性疾病或糖皮质激素治疗导致的血脂蛋白异常（DL）、抗磷脂抗体或肾病综合征引起的高凝状态、血管炎和高血压。有报道称DL与抗心磷脂抗体（aCL）的存在之间存在关联。饮食疗法是有帮助的，但许多患者在饮食调整和补充鱼油后仍有明显的DL。该亚组患者可能需要使用降脂药物。文中讨论了DL的潜在机制。还综述了预防动脉粥样硬化及其并发症的其他策略。
