Kaplan Mariana J
Division of Rheumatology, University of Michigan Medical School, Ann Arbor, MI 48109, USA.
Nat Rev Rheumatol. 2009 Apr;5(4):208-17. doi: 10.1038/nrrheum.2009.29.
Patients with chronic inflammatory disorders are at increased risk of developing premature cardiovascular disease. Despite significant advances in our understanding of the effects of inflammatory pathways on the vasculature, clear guidelines on the management of traditional and nontraditional cardiovascular risk factors in patients with systemic autoimmunity are lacking. Thus, rigorous studies assessing the individual contributions of the various treatments used in autoimmune disorders, as well as their effects on atherosclerosis development in these conditions, are needed. Furthermore, effective screening methods are needed to identify those patients with inflammatory disease who are at the highest risk for atherosclerotic complications, and who would benefit from early intervention. There is a clear need for a unifying explanation of the factors that promote premature cardiovascular disease in patients with chronic inflammatory disorders. Nevertheless, ongoing advances in the understanding of immune-mediated vascular damage mean that we are edging closer to the development of disease-specific preventive strategies to ameliorate or abrogate premature cardiovascular disease in these patients.
患有慢性炎症性疾病的患者患心血管疾病过早的风险增加。尽管我们对炎症途径对血管系统的影响的理解有了重大进展，但对于系统性自身免疫患者传统和非传统心血管危险因素的管理仍缺乏明确的指导方针。因此，需要进行严格的研究，评估自身免疫性疾病中使用的各种治疗方法的个体作用，以及它们在这些情况下对动脉粥样硬化发展的影响。此外，需要有效的筛查方法来识别那些患动脉粥样硬化并发症风险最高、且能从早期干预中获益的炎症性疾病患者。显然需要对促进慢性炎症性疾病患者心血管疾病过早发生的因素作出统一解释。然而，对免疫介导的血管损伤认识的不断进步意味着，我们正在更接近开发针对特定疾病的预防策略，以改善或消除这些患者的心血管疾病过早发生的情况。
