类风湿关节炎与心血管疾病。
Rheumatoid arthritis and cardiovascular disease.
机构信息
Mayo Clinic, Rochester, MN.
出版信息
Am Heart J. 2013 Oct;166(4):622-628.e1. doi: 10.1016/j.ahj.2013.07.010. Epub 2013 Aug 29.
Abstract
BACKGROUND
Rheumatic disease and heart disease share common underpinnings involving inflammation. The high levels of inflammation that characterize rheumatic diseases provide a "natural experiment" to help elucidate the mechanisms by which inflammation accelerates heart disease. Rheumatoid arthritis (RA) is the most common of the rheumatic diseases and has the best studied relationships with heart disease.
METHODS
A review of current literature on heart disease and RA was conducted.
RESULTS
Patients with RA have an increased risk of developing heart disease that is not fully explained by traditional cardiovascular risk factors. Therapies used to treat RA may also affect the development of heart disease; by suppressing inflammation, they may also reduce the risk of heart disease. However, their other effects, as in the case of steroids, may increase heart disease risk.
CONCLUSIONS
Investigations of the innate and adaptive immune responses occurring in RA may delineate novel mechanisms in the pathogenesis of heart disease and help identify novel therapeutic targets for the prevention and treatment of heart disease.
摘要
背景
风湿性疾病和心脏病有共同的炎症基础。风湿性疾病的高水平炎症为阐明炎症加速心脏病的机制提供了一个“自然实验”。类风湿关节炎（RA）是最常见的风湿性疾病，与心脏病的关系也得到了最深入的研究。
方法
对当前关于心脏病和 RA 的文献进行了回顾。
结果
RA 患者患心脏病的风险增加，这不能完全用传统的心血管危险因素来解释。用于治疗 RA 的疗法也可能影响心脏病的发展；通过抑制炎症，它们也可能降低心脏病的风险。然而，它们的其他作用，如类固醇，可能会增加心脏病的风险。
结论
对 RA 中固有和适应性免疫反应的研究可能会阐明心脏病发病机制中的新机制，并有助于为心脏病的预防和治疗确定新的治疗靶点。
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