Hahn Bevra H, Grossman Jennifer, Chen Weiling, McMahon Maureen
Division of Rheumatology, Department of Medicine, David Geffen School of Medicine at the University of California Los Angeles, 1000 Veteran Avenue, Los Angeles, CA 90095, USA.
J Autoimmun. 2007 Mar-May;28(2-3):69-75. doi: 10.1016/j.jaut.2007.02.004. Epub 2007 Apr 16.
As patients with autoimmune rheumatic diseases live longer due to improved therapies and preventive measures, death and disability from atherosclerosis, particularly myocardial infarcts, are increasing. The relative risks for atherosclerosis vary from approximately 1.6 in ankylosing spondylitis and psoriatic arthritis to 3.0 in rheumatoid arthritis (RA), and 6.0 in systemic lupus erythematosus (SLE). Increased risks are found when analyzed by atherosclerotic events, causes of death, or surrogate measures of atherosclerosis, such as carotid artery plaque, intimal-media thickness, or coronary artery calcification. At all ages among adults, atherosclerosis is increased in patients with SLE or RA compared to healthy controls. For example, in women with SLE under the age of 40 years, approximately 13% have carotid plaque compared to 2% of controls; over age 59 the percentages are 71 and 45, respectively. For patients with RA, prevalence is 7% under the age of 40 in patients compared to zero in controls; over 59 years the prevalences are 80% and 44%, respectively. In this review we will discuss the mechanisms involved as well as an overview of the natural history in pathobiology.
由于治疗方法和预防措施的改进，自身免疫性风湿疾病患者的寿命得以延长，动脉粥样硬化导致的死亡和残疾，尤其是心肌梗死，正日益增加。动脉粥样硬化的相对风险在强直性脊柱炎和银屑病关节炎中约为1.6，在类风湿关节炎（RA）中为3.0，在系统性红斑狼疮（SLE）中为6.0。通过动脉粥样硬化事件、死亡原因或动脉粥样硬化的替代指标（如颈动脉斑块、内膜中层厚度或冠状动脉钙化）进行分析时，风险都会增加。在所有成年人年龄段中，与健康对照相比，SLE或RA患者的动脉粥样硬化风险均有所增加。例如，在40岁以下的SLE女性中，约13%有颈动脉斑块，而对照组为2%；59岁以上时，这两个百分比分别为71%和45%。对于RA患者，40岁以下患者的患病率为7%，而对照组为零；59岁以上时，患病率分别为80%和44%。在本综述中，我们将讨论其中涉及的机制以及病理生物学自然史的概述。
