Mukhtyar Chetan, Brogan Paul, Luqmani Raashid
Rheumatology Department, University of Oxford, Oxford, UK.
Best Pract Res Clin Rheumatol. 2009 Jun;23(3):419-28. doi: 10.1016/j.berh.2009.02.002.
The primary systemic vasculitides are a group of autoimmune conditions characterised by occlusion, stenosis or aneurysmal dilatation of blood vessels secondary to intra-mural inflammation. Current therapy has converted the outlook of these diseases from death or severe morbidity to a remitting-relapsing condition in most instances. Longer survival, relapsing course of disease and chronic glucocorticoid therapy probably contribute to an increase in cardiovascular events and morbidity. This article reviews the available data for effect of primary systemic vasculitis on cardiovascular end points like coronary artery disease, congestive cardiac failure, hypertension and aortic aneurysm in all age groups. We examine the interplay between the activated endothelium, autoimmune mechanisms and treatment factors to produce a direct insult or increased atherogenic potential of primary systemic vasculitis. Recommendations to deal with cardiovascular end points are made.
原发性系统性血管炎是一组自身免疫性疾病，其特征是由于壁内炎症继发血管闭塞、狭窄或动脉瘤样扩张。目前的治疗方法已使这些疾病的预后在大多数情况下从死亡或严重发病转变为缓解-复发状态。更长的生存期、疾病的复发过程以及长期糖皮质激素治疗可能导致心血管事件和发病率增加。本文综述了关于原发性系统性血管炎对各年龄组心血管终点（如冠状动脉疾病、充血性心力衰竭、高血压和主动脉瘤）影响的现有数据。我们研究了活化内皮、自身免疫机制和治疗因素之间的相互作用，以探讨原发性系统性血管炎如何造成直接损害或增加动脉粥样硬化风险。文中还给出了应对心血管终点的建议。
