Department of Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Tel-Aviv University, Israel.
Curr Pharm Des. 2010;16(32):3574-85. doi: 10.2174/138161210793797870.
Glucocorticoids (GC) are drugs commonly used, by approximately 1% of the total adult population as anti-inflammatory and immunosuppressive therapies for asthma, inflammatory bowel disease, dermatological, ophthalmic, neurological, and rheumatic autoimmune diseases. Supporting evidence exists of GC use in both immune mediated and non-immune mediated heart disease. The molecular mechanisms by which GC induces immune-modulation and direct cardioprotection, are complex and not fully understood. We review herein, the current knowledge of GC use in various immune-mediated or non-immune mediated cardiovascular conditions. GC have been investigated in autoimmune, inflammatory and idiopathic heart diseases such as atrio-ventricular conduction abnormalities, rheumatic fever, myocarditis, dilated cardiomyopathy, Churg-Strauss syndrome, Kawasaki disease and sarcoidosis. GC therapy has been studied in non-autoimmune and non-inflammatory indications such as acute myocardial infarction, angina, postpericardiotomy syndrome and other pericardial diseases, endocarditis and cardiac amyloidosis, as well as in invasive cardiology, coronary interventions, and cardiopulmonary-bypass surgery. Despite GC's role as natural, physiologic regulators of the immune system, cardiovascular adverse outcomes may occur. Some of the well-known side effects of GC therapy involve bone, metabolic, and cardiovascular systems and include osteoporosis, fractures, dyslipidemia, diabetes, obesity, and hypertension.
糖皮质激素（GC）是一种常用药物，大约有 1%的成年人将其作为抗炎和免疫抑制疗法，用于治疗哮喘、炎症性肠病、皮肤病、眼科、神经和风湿性自身免疫性疾病。有证据表明，GC 可用于治疗免疫介导和非免疫介导的心脏病。GC 通过免疫调节和直接心脏保护的分子机制非常复杂，尚未完全阐明。本文综述了 GC 在各种免疫介导或非免疫介导的心血管疾病中的应用。GC 已在自身免疫性、炎症性和特发性心脏病中进行了研究，如房室传导异常、风湿热、心肌炎、扩张型心肌病、Churg-Strauss 综合征、川崎病和结节病。GC 治疗也已在非自身免疫性和非炎症性疾病中进行了研究，如急性心肌梗死、心绞痛、心包切开术后综合征和其他心包疾病、心内膜炎和心脏淀粉样变性，以及在介入心脏病学、冠状动脉介入治疗和体外循环手术中进行了研究。尽管 GC 是免疫系统的天然生理调节剂，但仍可能导致心血管不良事件。GC 治疗的一些众所周知的副作用涉及骨骼、代谢和心血管系统，包括骨质疏松症、骨折、血脂异常、糖尿病、肥胖症和高血压。
