DOI: https://doi.org/10.22263/2312-4156.2020.3.14
Пальгуева А.Ю., Литвяков А.М.
Ревматоидный артрит и атеросклероз: фокус на хроническую инфекцию. Обзор литературы
Витебский государственный ордена Дружбы народов медицинский университет, г. Витебск, Республика Беларусь
Вестник ВГМУ. – 2020. – Том 19, №3. – С. 14-22.
Резюме.
Эпидемиологические, клинические и лабораторные исследования последних лет указывают на то, что системные ревматические заболевания сопровождаются прогрессирующим развитием атеросклероза и его осложнений и их следует рассматривать как независимые факторы риска атеросклеротической болезни.
Среди системных ревматических заболеваний с клиническим преобладанием суставного синдрома выделяется ревматоидный артрит (РА). Ведущей причиной преждевременной смертности пациентов с РА является кардиоваскулярная патология – инфаркт миокарда, сердечно-сосудистая недостаточность, инсульт. У молодых лиц с небольшой продолжительностью заболевания и при низкой активности воспалительного процесса было доказано наличие начальных изменений артерий атеросклеротического характера.
В основе атеросклероза и РА лежит хронический воспалительный процесс со схожими молекулярными и клеточными механизмами.
Одной из причин развития системного воспаления могут быть хронические инфекции. В качестве возможных кандидатов рассматриваются Chlamydophila pneumoniae, Mycoplasma pneumoniae, Helicobacter pylori, Herpes Simplex Virus-1, Cytomegalovirus.
Роль хронических бактериальных и вирусных инфекций в развитии атеросклероза частично может быть связана с их способностью вызывать изменения проатерогенного характера в липидном обмене.
Как и при атеросклерозе, в этиопатогенезе РА в качестве возможных триггерных факторов рассматриваются различные инфекционные агенты.
Ключевые слова: атеросклероз, ревматоидный артрит, атеросклеротическая бляшка, воспаление, инфекция.
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Сведения об авторах:
Пальгуева А.Ю. – к.м.н., доцент кафедры внутренних болезней, Витебский государственный ордена Дружбы народов медицинский университет;
Литвяков А.М. – д.м.н., профессор, заведующий кафедрой внутренних болезней, Витебский государственный ордена Дружбы народов медицинский университет.
Адрес для корреспонденции: Республика Беларусь, 210009, г. Витебск, пр. Фрунзе, 27, Витебский государственный ордена Дружбы народов медицинский университет, кафедра внутренних болезней. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Пальгуева Анна Юрьевна.
