Nemchinov E N, Kanevskaia M Z, Chichasova N V, Telepneva L M, Krel' A A
Ter Arkh. 1994;66(5):33-8.
The analysis of life-time diagnosis of valvular heart disease in rheumatoid arthritis (RA) patients has been made basing on a long-term clinico-echocardiographic investigation. Within 18-year follow-up valvular disease was revealed in 17 out of 214 RA patients (7.9%). Only 3 patients developed the disease in childhood prior to RA diagnosis. In 8 patients the diagnosis of valvular disease was established in the presence of RA, in 6 RA patients the disease was determined during the follow-up period. Mitral stenosis, aortal stenosis, combined mitral valve incompetence, combined aortal defect, mitral defect and tricuspid incompetence, combined mitral defect and pulmonary artery valvular incompetence were detected in 2, 2, 3, 1, 1, and 1 patients, respectively. Valvular disease occurs more frequently in progredient seropositive RA uncontrollable by on-going therapy. The authors emphasize the value of a prospective clinical echocardiographic examination of RA patients in early diagnosis of valvular disease in them. Frequent valvular lesions in RA patients dictate the need of persistent antirheumatic therapy to inhibit the activity and prevent progression of the disease.
基于一项长期临床超声心动图研究，对类风湿关节炎（RA）患者的瓣膜性心脏病终生诊断情况进行了分析。在18年的随访期内，214例RA患者中有17例（7.9%）发现患有瓣膜病。仅有3例患者在儿童期RA诊断之前就已患病。8例患者在患RA时确诊瓣膜病，6例RA患者在随访期间确诊该病。二尖瓣狭窄、主动脉瓣狭窄、二尖瓣关闭不全合并症、主动脉瓣缺损合并症、二尖瓣缺损和三尖瓣关闭不全、二尖瓣缺损合并肺动脉瓣关闭不全分别在2例、2例、3例、1例、1例和1例患者中被检测到。瓣膜病在持续治疗无法控制的进行性血清阳性RA患者中更常见。作者强调对RA患者进行前瞻性临床超声心动图检查对早期诊断其瓣膜病的价值。RA患者频繁出现瓣膜病变表明需要持续进行抗风湿治疗以抑制疾病活动并防止其进展。
