风湿免疫病患者并发心血管疾病的研究进展

风湿免疫病是一组常见的慢性疾病,主要影响关节、肌腱、韧带、骨骼和肌肉组织,这类疾病可导致身体的残疾。尽管由于早期的诊断,积极有效的治疗,在过去的几十年里,风湿免疫病患者的死亡率明显下降,然而,和正常人群相比,风湿免疫病患者的死亡率仍然很高。流行病学证据显示较高的死亡率归因于风湿免疫病患者较高的并发症,尤其是心血管并发症,如缺血性心脏疾病、心瓣膜疾病、心肌病、心包疾病和心脏传导系统的异常。尽管风湿免疫病患者伴发心血管疾病的机理尚不完全清楚,但是传统心血管病的风险因子如吸烟、缺乏锻炼、高血压、高血脂、高血糖,风湿免疫病患者体内持续的慢性炎症和药物治疗带来的副作用如糖皮质激素的长期应用等可能是风湿免疫病患者伴发心血管疾病的主要原因。风湿免疫病可增加患心血管疾病的风险,而心血管疾病又是风湿病患者死亡的首要原因。因此有效的预防和治疗心血管并发症非常重要,了解风湿免疫病患者的心血管疾病的伴发情况,可以更好的帮助患者预防这些并发症,延长寿命,提高生活质量。本文综述了近年来风湿免疫病患者伴发心血管疾病的临床常见情况及这些伴发疾病的发病机理和预防治疗的研究进展。

Advances in research on cardiovascular diseases in patients with rheumatic diseases

Rheumatic diseases are a group of chronic diseases that mainly affect joints, tendons, ligaments, bones and muscle tissues. These diseases can become an important public health problem because they can lead to physical disability. Although the mortality of patients with rheumatic diseases has decreased significantly over the past few decades due to early diagnosis and active and effective treatment, the mortality of patients with rheumatic diseases is still high compared with the normal population. Epidemiological evidence supports a higher mortality may be attributed to higher comorbidity in patients with rheumatic diseases, especially cardiovascular complications such as ischemic heart disease, heart valve disease, cardiomyopathy, pericardial disease and abnormalities in the heart conduction system. Although the mechanism of cardiovascular disease in patients with rheumatic diseases is not fully understood, the risk factors of traditional cardiovascular diseases such as smoking, lack of exercise, high blood pressure, high blood fat, high blood sugar, and persistent chronic inflammation in patients with rheumatic diseases, and side effects of drugs, such as long-term use of glucocorticoids, may be the main cause of cardiovascular diseases in patients with rheumatic diseases. Rheumatic diseases increase the risk of cardiovascular diseases, which is the leading cause of death in patients with rheumatic diseases. Therefore, it is very important to effectively prevent and treat cardiovascular complications. Understanding the comorbid condition of cardiovascular diseases in patients with rheumatic diseases can better help patients to prevent these complications, prolong life and improve their quality of life. Here, we mainly review the common comorbidity of cardiovascular diseases in patients with rheumatic diseases in recent years and the research progress of the pathogenesis and preventive treatment of these comorbid conditions.