Ревматоидный артрит: влияние воспаления и противовоспалительной терапии на кардиоваскулярные факторы риска

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Обзор; СтатьяМЕД СОВЕТ. 2020; № 11: 32–44. DOI:10.21518/2079-701X-2020-11-32-44

Ревматоидный артрит: влияние воспаления и противовоспалительной терапии на кардиоваскулярные факторы риска

Трухан Д.И.^[1]

Иванова Д.С.^[1]

Белус К.Д.^[1]

^[1]Омский государственный медицинский университет

Ревматоидный артрит является частым и одним из наиболее тяжелых иммуновоспалительных заболеваний человека, что определяет большое медицинское и социально-экономическое значение этой патологии. Одной из приоритетных проблем современной кардиоревматологии является повышенный риск сердечно-сосудистых осложнений при ревматоидном артрите. У пациентов с ревматоидным артритом выражены традиционные кардиоваскулярные факторы риска сердечно-сосудистых заболеваний (метаболический синдром, ожирение, дислипидемия, артериальная гипертензия, инсулинорезистентность, сахарный диабет, курение и гиподинамия) и генетическая предрасположенность. Определенное влияние оказывают и их специфические особенности: «липидный парадокс» и «парадокс ожирения». Однако ведущую роль в заболеваемости и смертности от сердечно-сосудистых заболеваний при ревматоидном артрите занимает хроническое воспаление как ключевой фактор развития прогрессирования атеросклероза и эндотелиальной дисфункции. В представленном обзоре рассмотрены влияние хронического воспаления и его медиаторов на традиционные кардиоваскулярные факторы риска и его самостоятельное значение в развитии ССЗ. Определенное влияние на кардиоваскулярные факторы риска у пациентов с РА оказывает и лекарственная терапия (нестероидные противовоспалительные препараты, глюкокортикостероиды, базисные противовоспалительные препараты, генно-инженерные биологические препараты) основного заболевания. Проведенный обзор исследований по этой проблеме позволяет предполагать позитивное влияние фармакологического вмешательства при ревматоидном артрите на кардиоваскулярные факторы риска, их снижение до уровня, сопоставимого с популяциями пациентов, не страдающих ревматоидным артритом. Взаимодействие ревматологов, кардиологов и врачей первого контакта (терапевта и врача общей практики) в изучении механизмов развития атеросклероза у больных ревматоидным артритом позволит в реальной клинической практике разработать адекватные методы своевременной диагностики и профилактики сердечно-сосудистых заболеваний у пациентов ревматоидным артритом.

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Язык текста: Русский

ISSN: 2079-701X

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URI:4e432d4d4544534f5645542d41525449434c452d323032302d302d31312d302d33322d3434

Унифицированный идентификатор ресурса для цитирования: //medj.rucml.ru/journal/4e432d4d4544534f5645542d41525449434c452d323032302d302d31312d302d33322d3434/