Atherosclerosis in systemic lupus erythematosus.
Atherosclerosis in systemic lupus erythematosus.
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DOI：
10.1097/fjc.0b013e31829dd857
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发表时间：
2013-09
影响因子：
3
通讯作者：
Petri M
中科院分区：
文献类型：
--
作者：
Stojan G;Petri M
加速的动脉粥样硬化及其长期后遗症是系统性红斑狼疮（SLE）患者晚期死亡的主要原因。传统的心脏病风险因素，如高血压、高胆固醇血症、糖尿病和吸烟并不能完全解释这种风险。SLE特异性因素如疾病活动性和持续时间、皮质类固醇的使用、抗磷脂抗体的存在等是重要的危险因素。SLE被认为是冠心病;建议对所有传统危险因素进行同等和积极的管理。尽管他汀类药物在一般人群中的一级和二级预防中发挥作用，但在成人或儿童SLE人群中，他汀类药物似乎对心血管结局没有影响。使用羟氯喹具有心脏保护作用，基于基础科学数据和移植人群的数据，霉酚酸酯可能会减少心血管事件。补充维生素D和治疗高同型半胱氨酸血症的作用仍有争议，但由于治疗的安全性和潜在的益处，它们仍然是可选的治疗方法。
Accelerated atherosclerosis and its long-term sequelae are a major cause of late mortality among patients with systemic lupus erythematosus (SLE). Traditional Framingham risk factors such as hypertension, hypercholesterolemia, diabetes, and smoking do not account in entirety for this risk. SLE specific factors like disease activity and duration, use of corticosteroids, presence of antiphospholipid antibodies, and others are important risk factors. SLE is considered a coronary heart disease; equivalent and aggressive management of all traditional risk factors is recommended. Despite their role in primary and secondary prevention in the general population, statins seem to have no effect on cardiovascular outcomes in adult or pediatric SLE populations. The use of hydroxychloroquine has a cardioprotective effect, and mycophenolate mofetil may reduce cardiovascular events based on basic science data and data from the transplant population. The role of vitamin D supplementation and treatment of hyperhomocysteinemia remain controversial, but due to the safety of therapy and the potential benefit, they remain as optional therapies.