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英国系统性硬化症研究小组的共识最佳实践路径:系统性硬化症中心脏病的管理

Consensus best practice pathway of the UK Systemic Sclerosis Study group: management of cardiac disease in systemic sclerosis.

作者信息

Bissell Lesley-Anne, Anderson Marina, Burgess Malcolm, Chakravarty Kuntal, Coghlan Gerry, Dumitru Raluca B, Graham Lee, Ong Voon, Pauling John D, Plein Sven, Schlosshan Dominik, Woolfson Peter, Buch Maya H

机构信息

Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds.

NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds.

出版信息

Rheumatology (Oxford). 2017 Jun 1;56(6):912-921. doi: 10.1093/rheumatology/kew488.

Abstract

OBJECTIVE

Cardiac disease in SSc can manifest in various ways and is associated with a poor prognosis. There is little evidence on how best to detect and manage cardiac disease in SSc. Our objective was to produce an expert consensus best practice pathway for the management of cardiac disease in SSc.

METHODS

The UK Systemic Sclerosis Study Group set up several working groups to develop a number of consensus best practice pathways for the management of SSc-specific complications, including cardiac disease. A multidisciplinary task force was convened. The guidelines were partly informed by a comprehensive literature review.

RESULTS

A best practice pathway for cardiac disease (with a focus on primary cardiac disease) in SSc is presented, including approaches for early detection and standard pharmacological and device therapies. Due to the benefits, shared care and a multidisciplinary approach are recommended. A future research agenda has been formulated in response to the relative lack of understanding of the natural history of primary cardiac disease that was highlighted by the initiative.

CONCLUSION

The physician should be alert to the possibility of cardiac disease in SSc; it is best managed within a multidisciplinary team including both rheumatologists and cardiologists. This pathway provides a reference for all physicians managing patients with SSc.

摘要

目的

系统性硬化症(SSc)中的心脏疾病可通过多种方式表现出来,且与预后不良相关。关于如何最好地检测和管理SSc中的心脏疾病,证据很少。我们的目标是制定一份专家共识最佳实践路径,用于管理SSc中的心脏疾病。

方法

英国系统性硬化症研究小组设立了几个工作组,以制定一些关于管理SSc特异性并发症(包括心脏疾病)的共识最佳实践路径。召集了一个多学科特别工作组。这些指南部分基于全面的文献综述。

结果

提出了SSc中心脏疾病(重点是原发性心脏疾病)的最佳实践路径,包括早期检测方法以及标准的药物和器械治疗。鉴于其益处,建议采用共享护理和多学科方法。针对该倡议所强调的对原发性心脏疾病自然史相对缺乏了解的情况,制定了未来研究议程。

结论

医生应警惕SSc中存在心脏疾病的可能性;最好在包括风湿病学家和心脏病学家的多学科团队中进行管理。该路径为所有管理SSc患者的医生提供了参考。

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