Malaviya Anshuman P, Hall Frances C
Rheumatology Clinical Research Unit, Addenbrooke's Hospital, Cambridge.
Practitioner. 2012 Jan;256(1747):21-6, 3.
Chronic inflammatory rheumatological conditions are associated with an increased burden of cardiovascular disease (CVD). In both rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) most excess mortality is cardiovascular. Increased CVD risk is also associated with psoriatic arthritis, ankylosing spondylitis, antiphospholipid syndrome and systemic sclerosis. Several studies report that CVD mortality increases early in disease in RA, with increased risk of MI within one year and increased risk of hospital admission for CVD within seven years of diagnosis. A linear association has been demonstrated between subclinical carotid atherosclerosis and raised inflammatory markers. SLE is associated with 2-10 times the risk of a CVD event compared with the general population. CVD is now a leading cause of morbidity and mortality in SLE. Antiphospholipid antibodies are associated with accelerated atherosclerosis, as well as thromboses. Atherogenesis in the context of autoimmune disease results from a complex interplay between traditional risk factors, disease-specific factors and drug-related adverse effects. Chronic inflammation itself modifies the lipid profile.
慢性炎症性风湿性疾病与心血管疾病（CVD）负担增加相关。在类风湿关节炎（RA）和系统性红斑狼疮（SLE）中，大多数额外死亡原因是心血管疾病。银屑病关节炎、强直性脊柱炎、抗磷脂综合征和系统性硬化症也与心血管疾病风险增加有关。多项研究报告称，RA患者在疾病早期心血管疾病死亡率就会增加，诊断后一年内心肌梗死风险增加，七年内因心血管疾病住院的风险增加。亚临床颈动脉粥样硬化与炎症标志物升高之间已证实存在线性关联。与普通人群相比，SLE发生心血管疾病事件的风险高出2至10倍。心血管疾病现在是SLE发病和死亡的主要原因。抗磷脂抗体与动脉粥样硬化加速以及血栓形成有关。自身免疫性疾病背景下的动脉粥样硬化形成是传统危险因素、疾病特异性因素和药物相关不良反应之间复杂相互作用的结果。慢性炎症本身会改变血脂谱。
