Thomas G N, Tam L S, Tomlinson B, Li E K
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Hong Kong Med J. 2002 Feb;8(1):26-32.
Systemic lupus erythematosus is an autoimmune disorder affecting multiple organ systems. Patients with systemic lupus erythematosus exhibit a bimodal pattern of mortality, with those who have had the disease for 5 to 10 years being at increased risk of cardiovascular disease, particularly myocardial infarction. Elevated levels of conventional cardiovascular risk factors promote vascular damage resulting in impairment of normal endothelial function. In addition, autoantibodies directed against oxidised lipoproteins, along with chronic secretion of inflammatory cytokines and suppression of fibrinolytic parameters, are thought to increase atherogenesis. Treatment with corticosteroids may also contribute to the accelerated atherosclerosis observed in these patients. This review discusses the accentuated relationship between conventional cardiovascular risk factors, systemic lupus erythematosus-induced inflammatory changes and the early stages of atherogenesis and how careful monitoring of risk factors and use of appropriate therapies may reduce the progression of atheroma development in patients with systemic lupus erythematosus.
系统性红斑狼疮是一种影响多个器官系统的自身免疫性疾病。系统性红斑狼疮患者呈现双峰死亡率模式，患病5至10年的患者患心血管疾病尤其是心肌梗死的风险增加。传统心血管危险因素水平升高会促进血管损伤，导致正常内皮功能受损。此外，针对氧化脂蛋白的自身抗体，以及炎症细胞因子的慢性分泌和纤维蛋白溶解参数的抑制，被认为会增加动脉粥样硬化的发生。使用皮质类固醇进行治疗也可能导致这些患者出现加速的动脉粥样硬化。本综述讨论了传统心血管危险因素、系统性红斑狼疮引起的炎症变化与动脉粥样硬化早期阶段之间的加剧关系，以及如何通过仔细监测危险因素和使用适当的治疗方法来减少系统性红斑狼疮患者动脉粥样硬化的发展进程。
