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Ocular involvement in rheumatic diseases. 风湿病对眼部的影响。
Q3 RHEUMATOLOGY Pub Date : 2023-01-01 Epub Date: 2023-10-31 DOI: 10.5114/reum/172767
Iwona Dankiewicz-Fares, Daniel Jeka, Tacjana Barczyńska

Rheumatic diseases are associated with a significant decline in quality of life, which is not only related to the progression of the underlying disease but also to the development of coexisting conditions. One of the possible complications in this group of diseases is ocular involvement. Impaired vision is strongly associated with a significant decline in quality of life and can also exacerbate problems related to physical functioning. Consequently, it can lead to serious complications in the treatment of the underlying disease. Additionally, from a clinical point of view, it is also important to note that ocular diseases may precede the occurrence of inflammatory joint and spinal diseases, as well as organ involvement in systemic connective tissue disorders. Therefore, paying attention to ocular symptoms can help in early diagnosis and thus improve patient prognosis. For the aforementioned reasons, ocular diseases should be carefully considered in routine rheumatologic practice.

风湿性疾病与生活质量的显著下降有关,这不仅与潜在疾病的进展有关,而且与共存条件的发展有关。这类疾病可能的并发症之一是眼部受累。视力受损与生活质量的显著下降密切相关,也可能加剧与身体功能有关的问题。因此,它可能导致治疗潜在疾病的严重并发症。此外,从临床角度来看,同样重要的是要注意,眼部疾病可能先于炎性关节和脊柱疾病的发生,以及系统性结缔组织疾病的器官受累。因此,关注眼部症状有助于早期诊断,从而改善患者预后。由于上述原因,在常规风湿病实践中应仔细考虑眼部疾病。
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引用次数: 0
Co-existence of spina bifida occulta and lumbosacral transitional vertebra in patients presenting with lower back pain 以下背部疼痛为表现的隐性脊柱裂和腰骶过渡椎体共存
Q3 RHEUMATOLOGY Pub Date : 2022-02-28 DOI: 10.5114/reum.2022.114171
Ashish Sharma, Ashok Kumar, Anoushka Kapila
Lower back pain is a common symptom, which is managed by various specialties including neurology, orthopedics, general medicine, and rheumatology. Lumbosacral transitional vertebra (LSTV) is an important cause of back pain, about which many clinicians are unfamiliar. It is a congenital malformation of the spine, which results from abnormal fusion of the sacrum with the vertebra above, to a variable extent. An extra joint is formed between the ala of sacrum and the elongated transverse process of the vertebra above on one or both sides. It leads to altered rotational movement of the lower spine, which gives rise to back pain. Spina bifida occulta (SBO) is another congenital malformation of the spine, which is detected incidentally because it does not cause any symptoms. We observed frequent co-existence of SBO and LSTV in patients attending our rheumatology clinic for lower back pain.
腰痛是一种常见的症状,治疗方法包括神经病学、骨科、普通医学和风湿病学。腰骶过渡椎(LSTV)是引起腰痛的一个重要原因,许多临床医生对此并不熟悉。这是一种脊柱的先天性畸形,是由于骶骨与上面的椎体在不同程度上的异常融合造成的。在骶骨瓣和上面一侧或两侧的椎骨的细长横突之间形成一个额外的关节。它会改变下脊柱的旋转运动,从而引起背部疼痛。隐匿性脊柱裂(SBO)是脊柱的另一种先天性畸形,由于没有任何症状而被偶然发现。我们观察到经常并发SBO和LSTV的患者来我们的风湿病诊所治疗腰痛。
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引用次数: 2
Association between forkhead box P3 expression level and gender of Iranian juvenile idiopathic arthritis patients 伊朗青少年特发性关节炎患者叉头盒P3表达水平与性别的关系
Q3 RHEUMATOLOGY Pub Date : 2022-02-28 DOI: 10.5114/reum.2022.114228
A. Ghavidel, S. Farivar, Shahin Aghamiri, R. Shiari
Objectives Juvenile idiopathic arthritis (JIA) is a childhood autoimmune rheumatoid disease. Past studies have confirmed that JIA is a complex disease, which means that genes and environmental factors affect the aetiology of the disease. In this study, we analysed the expression of interleukin 32, forkhead box P3 (FOXP3), methyl-CpG binding domain protein 1 (MBD1), and methyl-CpG-binding protein 2 (MECP2) in peripheral blood mononuclear cells of children with JIA in comparison with the expression of those in healthy children. Interleukin 32 is an inflammatory factor, FOXP3 is a transcription factor, and MBD1 and MECP2 are binding proteins that bind to the methylated deoxyribonucleic acid (DNA). Material and methods We collected blood from JIA patients who had been diagnosed and classified into clinical subtypes by a rheumatologist from the division of paediatric rheumatology. Healthy children, whose clinical and preclinical analysis confirmed they had no disease and just came to the hospital for a check-up or minor surgical procedures were considered as a control group. Age and gender were matched in patients and the control group. Total ribonucleic acid was extracted from blood, and cDNA was synthesized. Eventually, the transcript levels were analysed by quantitative polymerase chain reaction, and statistical analysis was carried out. Results Statistical analysis of gene expressions in young females affected by JIA demonstrated that MECP2 and FOXP3 were increased significantly (p-value = 0.002 and 0.05, respectively). Interleukin 32 gene expression was also increased (p-value = 0.14), whereas MBD1 gene expression was decreased (p-value = 0.06); however, these changes in the expression of all 4 genes were not significant in young males. Conclusions Different expression levels of the mentioned genes between affected young females and males result from hormones in both gender and also methotrexate (MTX) drug. Also, the reason affected young females are more prone to JIA than males can be the lower level of FOXP3 expression in healthy females than healthy males.
目的:青少年特发性关节炎(JIA)是一种儿童期自身免疫性类风湿性疾病。过去的研究证实JIA是一种复杂的疾病,这意味着基因和环境因素影响了疾病的病因。本研究分析JIA患儿外周血单个核细胞中白细胞介素32、叉头盒P3 (FOXP3)、甲基- cpg结合域蛋白1 (MBD1)、甲基- cpg结合蛋白2 (MECP2)的表达情况,并与健康患儿进行比较。白细胞介素32是一种炎症因子,FOXP3是一种转录因子,MBD1和MECP2是与甲基化脱氧核糖核酸(DNA)结合的结合蛋白。材料与方法我们采集经儿科风湿病科风湿病专家诊断并划分临床亚型的JIA患者的血液。临床和临床前分析证实他们没有疾病,只是来医院做检查或小手术的健康儿童被视为对照组。患者与对照组年龄、性别匹配。从血中提取总核糖核酸,合成cDNA。最后通过定量聚合酶链反应分析转录本水平,并进行统计分析。结果经统计学分析,年轻女性JIA患者MECP2、FOXP3基因表达显著升高(p值分别为0.002、0.05)。白细胞介素32基因表达升高(p值= 0.14),MBD1基因表达降低(p值= 0.06);然而,这4个基因在年轻雄性中的表达变化不显著。结论上述基因在年轻女性和男性之间的表达水平不同与两性激素和甲氨蝶呤(MTX)药物有关。同时,受影响的年轻女性比男性更容易发生JIA的原因可能是健康女性的FOXP3表达水平低于健康男性。
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引用次数: 0
Routine IgG4 staining in minor salivary gland biopsy in a cohort of Italian Caucasian patients suffering from xerostomia 意大利白种人口干症患者小唾液腺活检常规IgG4染色
Q3 RHEUMATOLOGY Pub Date : 2022-02-28 DOI: 10.5114/reum.2022.114207
E. Conticini, R. D’Alessandro, M. Bardelli, P. Falsetti, S. Gentileschi, V. Mancini, L. Cantarini, B. Frediani
Objectives IgG4-related disease is a potentially systemic disease mimicking and overlapping with different autoimmune diseases, such as primary Sjögren’s syndrome (pSS). The involvement of salivary glands, previously called Mikulicz’s disease, has been reclassified as IgG4-related sialadenitis (SA). The aim of this study was to assess the prevalence of IgG4-SA in a cohort of Italian Caucasian patients presenting with xerostomia and to evaluate the eventual overlap between IgG4-SA and pSS. Material and methods We included 154 patients – 15 males and 139 females, mean age 54.18 ±14.24 years, who underwent minor salivary gland biopsy between March and December 2019 for xerostomia. Histopathology was evaluated using Chisholm-Mason (CM) and focus score (FS) for pSS and immunohistochemical study with IgG4 staining for IgG4-SA were performed. Serum autoantibodies (anti-SSa/RoAb, anti-SSB/LaAb, antinuclear antibodies, rheumatoid factor) were also assessed. Results In 69 patients (44.8%) FS 0 was found, while FS ≥ 1 was presented in 85 (55.2%). Chisholm-Mason score < 3 and CM ≥ 3 was found in 73 (47.4%) and 81 (52.6%) cases, respectively. IgG4/high-power field level was 20 in 3 pSS patients (1.9%), but none of them had an IgG4/IgG ratio ≥ 40, as well as tissue fibrosis with storiform pattern, obliterative vasculitis, and tissue eosinophilia. The diagnosis of pSS, was confirmed in 92 patients (59.74%). No patient was definitively diagnosed with an IgG4-related disease. Conclusions In the case of xerostomia, the evaluation of the histopathological specimen for IgG4 should not be routinely performed, at least in an Italian-based Caucasian population. Moreover, immunohistochemistry should not be requested in the case of a negative result of biopsy for pSS.
igg4相关疾病是一种潜在的全身性疾病,与不同的自身免疫性疾病相似并重叠,如原发性Sjögren综合征(pSS)。累及唾液腺,以前称为Mikulicz病,已被重新分类为igg4相关涎腺炎(SA)。本研究的目的是评估IgG4-SA在一组意大利高加索口干症患者中的患病率,并评估IgG4-SA与pSS之间的最终重叠。材料和方法我们纳入了154例患者,其中男性15例,女性139例,平均年龄54.18±14.24岁,于2019年3月至12月因口干症接受了轻微唾液腺活检。采用Chisholm-Mason (CM)和focus score (FS)对pSS进行组织病理学评估,并采用IgG4- sa染色进行免疫组织化学研究。同时检测血清自身抗体(抗ssa /RoAb、抗ssb /LaAb、抗核抗体、类风湿因子)。结果69例(44.8%)患者FS为0,85例(55.2%)患者FS≥1。Chisholm-Mason评分< 3者73例(47.4%),CM≥3者81例(52.6%)。3例pSS患者IgG4/高倍视野水平为20(1.9%),但均无IgG4/IgG比值≥40、呈故事状的组织纤维化、闭塞性血管炎、组织嗜酸性粒细胞增多。确诊pSS 92例(59.74%)。没有患者被明确诊断为igg4相关疾病。结论:在口干症病例中,至少在意大利高加索人群中,不应常规进行IgG4的组织病理学标本评估。此外,在pSS活检结果为阴性的情况下,不应要求免疫组织化学。
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引用次数: 0
Nailfold capillaroscopy changes with disease activity in patients with inflammatory myositis including overlap myositis, pure dermatomyositis, and pure polymyositis 炎性肌炎包括重叠性肌炎、单纯皮肌炎和单纯多发性肌炎患者的甲襞毛细血管镜检查随疾病活动度的变化
Q3 RHEUMATOLOGY Pub Date : 2022-02-28 DOI: 10.5114/reum.2022.114109
S. Shenavandeh, F. Rashidi
Objectives Nailfold capillaroscopy (NFC) is useful in the evaluation of connective tissue diseases. There are few capillaroscopy examinations in patients with idiopathic inflammatory myopathies (IIMs) using the 2017 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification. We evaluated the clinical, laboratory, and NFC in patients with IIMs using 2 classifications. Material and methods In this cross-sectional study, 150 patients with IIMs were selected based on the EULAR/ACR classification and the Troyanov and Senécal classification. Nailfold capillaroscopy, laboratory tests, clinical manifestations, and disease activity were evaluated. Results The subgroups were as follows: 81 patient with dermatomyositis (DM), 25 with amyopathic dermatomyositis (ADM), 25 with juvenile dermatomyositis (JDM), 19 with polymyositis (PM),53 with pure DM, 11 with pure PM, and 51 with overlap myositis (OM). Eight (42%) patients with PM and 28 (34.5%) patients with DM were categorized as OM. The scleroderma pattern was the dominant capillaroscopy pattern in the DM (72.8%), JDM (72%), ADM (76%), pure DM (75.4%), and OM (78.4%) subgroups, respectively. In the DM, ADM, JDM, and OM subgroups, scleroderma pattern had an association with high skin Visual Analogue Scale (VAS) score (p < 0.05). In OM patients, the association between scleroderma pattern and high global VAS was also detected (p < 0.05). Conclusions The scleroderma pattern was the dominant capillaroscopy pattern in all groups except for PM and pure PM. Some of patients with PM could be categorized as OM. In the DM and pure DM subgroups, there was a significant association between global and skin activity and higher NFC score. Adding the NFC to the classification of IIM is probably helpful in more detailed classifications.
目的甲襞毛细血管镜检查(NFC)在结缔组织疾病诊断中的应用价值。根据2017年欧洲抗风湿病联盟/美国风湿病学会(EULAR/ACR)分类,特发性炎症性肌病(IIMs)患者很少进行毛细血管镜检查。我们使用两种分类方法评估IIMs患者的临床、实验室和NFC。材料和方法在本横断面研究中,根据EULAR/ACR分类和Troyanov和sensamucal分类选择了150例IIMs患者。甲襞毛细血管镜检查、实验室检查、临床表现和疾病活动度进行评估。结果:皮肌炎(DM) 81例,肌萎缩性皮肌炎(ADM) 25例,幼年皮肌炎(JDM) 25例,多发性肌炎(PM) 19例,单纯DM 53例,单纯PM 11例,重叠性肌炎(OM) 51例。PM患者8例(42%),DM患者28例(34.5%)为OM。在DM(72.8%)、JDM(72%)、ADM(76%)、纯DM(75.4%)和OM(78.4%)亚组中,硬皮病模式是主要的毛细血管镜模式。在DM、ADM、JDM和OM亚组中,硬皮病类型与高皮肤视觉模拟评分(VAS)呈正相关(p < 0.05)。在OM患者中,硬皮病类型与高全局VAS之间也存在相关性(p < 0.05)。结论除PM和纯PM外,其余各组均以硬皮病型为主。部分PM患者可归类为OM。在糖尿病和纯糖尿病亚组中,整体和皮肤活动与较高的NFC评分之间存在显著关联。将NFC添加到IIM的分类中可能有助于更详细的分类。
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引用次数: 2
Statin-induced necrotizing autoimmune myopathy: a systematic review 他汀类药物诱导的坏死性自身免疫性肌病:一项系统综述
Q3 RHEUMATOLOGY Pub Date : 2022-02-28 DOI: 10.5114/reum.2022.114108
M. Somagutta, N. Shama, M. K. Pormento, R. Jagani, N. Ngardig, Klodin Ghazarian, Greta Mahmutaj, Khaled El-Faramawy, Ashwini Mahadevaiah, M. Jain
Statins are a class of lipid-lowering medications used worldwide by millions of people and are safe for frequent use in most patients. However, they cause necrotizing autoimmune myopathy in some patients. We reviewed case reports of 80 patients from 2010 to present diagnosed with statin-induced necrotizing autoimmune myopathy (SINAM), aiming to analyze the clinical, physiological, serologic characteristics and outcomes of SINAM. The mean age of these patients was 66 ±9.4, the majority being male (61.3%). All patients reported proximal muscle weakness, and a few had myalgias, extra muscular symptoms such as dysphagia, and pulmonary complications. Most of the patients were on atorvastatin, simvastatin, or rosuvastatin. The mean creatine kinase was 10,094.2 ±7,351.7 U/l, and anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase enzyme was positive for 93.8% of patients. The majority of patients were started on steroids; other treatments were also used. Prompt cessation of statins and initiation of immunosuppressants reduced morbidity and mortality.
他汀类药物是全球数百万人使用的一类降脂药物,对大多数患者来说是安全的。然而,它们在一些患者中引起坏死性自身免疫性肌病。我们回顾了2010年至今诊断为他汀类药物诱导的坏死性自身免疫性肌病(SINAM)的80例病例报告,旨在分析SINAM的临床、生理、血清学特征和转归。患者平均年龄66±9.4岁,男性居多(61.3%)。所有患者均报告近端肌肉无力,少数患者有肌痛、肌肉外症状,如吞咽困难和肺部并发症。大多数患者服用阿托伐他汀、辛伐他汀或瑞舒伐他汀。肌酸激酶平均值为10094.2±7351.7 U/l,抗3-羟基-3-甲基戊二酰辅酶A还原酶阳性的占93.8%。大多数患者开始使用类固醇;还使用了其他治疗方法。及时停用他汀类药物并开始使用免疫抑制剂可降低发病率和死亡率。
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引用次数: 5
Could IL-1β, IL-6, IFN-γ, and sP-selectin serum levels be considered as objective and quantifiable markers of rheumatoid arthritis severity and activity? IL-1β、IL-6、IFN-γ和sp -选择素的血清水平是否可以作为类风湿关节炎严重程度和活动性的客观和可量化的指标?
Q3 RHEUMATOLOGY Pub Date : 2022-02-28 DOI: 10.5114/reum.2022.114351
O. Koper-Lenkiewicz, E. Gińdzieńska-Sieśkiewicz, Joanna Kamińska, A. Milewska, O. Kowal-Bielecka, J. Matowicka-Karna
Objectives Rheumatoid arthritis (RA) is a multisystem, chronic, T-cell-mediated disease in which immunological abnormalities result in symmetrical small joint inflammation, articular destruction due to synovitis, and extra-articular organ involvement. An important role in the pathogenesis of RA is attributed to a combination of genetic factors and environmental triggers. Literature data on the utility of circulating IL-1β, IL-6, IFN-γ, and sP-selectin concentration evaluation depending on the activity and advancement of RA seems to be inconclusive. The aim was a case-control study evaluating IL-1β, IL-6, IFN-γ, and sP-selectin concentrations in 77 RA patients dependent on the Steinbrocker classification as well as the disease activity score with examination of 28 joints (DAS28), and compared to 30 control subjects. Material and methods Serum IL-1β, IL-6, IFN-γ, and sP-selectin concentrations were measured using ELISA kits. Results The concentrations of all molecules tested, except for IL-1β, were significantly different from the control group. Univariate logistic regression analysis indicated that their levels significantly influenced the likelihood of RA diagnosis. Differences between IL-1β, IL-6, IFN-γ, and sP-selectin concentrations dependent on the disease activity assessed on the basis of the DAS28 score, as well as the severity of the disease assessed based on the Steinbrocker classification, were not observed. IL-6 positively correlated with the DAS28 score. Conclusions Among the tested molecules, only IL-6 positively correlated with the DAS28 score. Thus, we postulate that next to C-reactive protein and the erythrocyte sedimentation rate, also IL-6 could be clinically relevant and possibly reflects RA activity. Because recently the IL-6 concentration can be determined in applied in vitro diagnostic tests, it presents us with the possibility to test this protein as a marker of RA activity in routine laboratory practice.
类风湿关节炎(RA)是一种多系统、慢性、t细胞介导的疾病,免疫异常导致对称小关节炎症、滑膜炎引起的关节破坏和关节外器官受累。在RA的发病机制中起重要作用的是遗传因素和环境触发因素的结合。关于循环IL-1β, IL-6, IFN-γ和sp -选择素浓度评估依赖于RA的活性和进展的效用的文献数据似乎尚无定论。目的是一项病例对照研究,评估77例RA患者的IL-1β, IL-6, IFN-γ和sp -选择素浓度,依赖于Steinbrocker分类以及28个关节检查的疾病活动评分(DAS28),并与30名对照受试者进行比较。材料与方法采用ELISA试剂盒检测血清IL-1β、IL-6、IFN-γ和sp -选择素浓度。结果除IL-1β外,各组分子浓度均与对照组有显著差异。单因素logistic回归分析表明,它们的水平显著影响RA诊断的可能性。未观察到IL-1β、IL-6、IFN-γ和sp -选择素浓度之间的差异,这些差异取决于基于DAS28评分评估的疾病活动性,以及基于Steinbrocker分类评估的疾病严重程度。IL-6与DAS28评分呈正相关。结论在检测的分子中,只有IL-6与DAS28评分呈正相关。因此,我们假设除了c反应蛋白和红细胞沉降率外,IL-6也可能与临床相关,并可能反映RA的活性。由于最近IL-6的浓度可以在体外诊断试验中测定,这为我们提供了在常规实验室实践中检测该蛋白作为RA活性标记物的可能性。
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引用次数: 0
EMEUNET and the Section of Young Rheumatologists of the Polish Society of Rheumatology activities – an update EMEUNET和波兰风湿病学会青年风湿病学家分会的活动-更新
Q3 RHEUMATOLOGY Pub Date : 2022-02-28 DOI: 10.5114/reum.2022.114260
Magdalena Włoch-Targońska, A. Opinc
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引用次数: 0
Methods of assessment of joint involvement in various systemic connective tissue diseases 各种系统性结缔组织疾病中关节受累的评估方法
Q3 RHEUMATOLOGY Pub Date : 2022-02-28 DOI: 10.5114/reum.2022.114186
Tobiasz Kardas, E. Wielosz, M. Majdan
Joint involvement is one of the most common clinical manifestations of systemic connective tissue diseases (CTD). Joint symptoms can take various forms, ranging from joint pain to mono-arthritis or symmetrical poly-arthritis. In most cases, arthritis takes a non-destructive form, such as in the course of systemic lupus erythematosus or primary Sjögren’s syndrome, to destructive arthritis in overlap syndromes of CTD with rheumatoid arthritis. In addition, apart from the wide variety of forms of joint involvement, it should be noted that joint symptoms may be one of the domains suggesting a severe course of the disease. The study attempts to present the methods of assessing the involvement of the locomotor system. The search for appropriate scales to determine the degree of joint involvement is important in assessing the severity of joint changes, has an impact on the overall degree of disease activity, and allows for timely implementation of appropriate treatment.
关节受累是全身性结缔组织病(CTD)最常见的临床表现之一。关节症状可以有多种形式,从关节疼痛到单纯性关节炎或对称性多发性关节炎。在大多数情况下,关节炎采取非破坏性形式,如在系统性红斑狼疮或原发性Sjögren综合征的过程中,到CTD与类风湿关节炎重叠综合征的破坏性关节炎。此外,除了各种各样的关节受累形式外,应该注意的是,关节症状可能是提示疾病严重病程的领域之一。本研究试图提出评估运动系统受累的方法。寻找合适的尺度来确定关节受累程度对于评估关节变化的严重程度非常重要,对疾病活动的总体程度有影响,并允许及时实施适当的治疗。
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引用次数: 0
Inflammation and autoimmunity in atherosclerosis 动脉粥样硬化中的炎症和自身免疫
Q3 RHEUMATOLOGY Pub Date : 2022-02-28 DOI: 10.5114/reum.2022.113364
S. Surma, K. Filipiak
Atherosclerosis is a process whose onset can be observed even in the foetal period. A number of risk factors, such as hyperlipidaemia, hyperhomocysteinaemia, arterial hypertension, hyperuricaemia, smoking, metabolic syndrome, hypertriglyceridaemia, and diabetes, accelerate the progression of atherosclerotic lesions leading to the development of atherosclerotic cardiovascular disease (ASCVD) [1]. Atherosclerotic cardiovascular disease is defined as coronary artery disease (CAD), cerebrovascular disease, or peripheral arterial disease of atherosclerotic origin. This disease represents the number one cause of morbidity and mortality worldwide. The number of patients with cardiovascular diseases in the world in 2019 was 523 million, while the number of deaths due to them reached 18.6 million [2].
动脉粥样硬化是一个甚至在胎儿期就可以观察到的发病过程。许多危险因素,如高脂血症、高同型半胱氨酸血症、动脉高血压、高尿酸血症、吸烟、代谢综合征、高甘油三酯血症和糖尿病,加速了动脉粥样硬化病变的进展,导致动脉粥样硬化性心血管疾病(ASCVD)的发展。动脉粥样硬化性心血管疾病被定义为冠状动脉疾病(CAD)、脑血管疾病或动脉粥样硬化起源的外周动脉疾病。这种疾病是全世界发病率和死亡率的头号原因。2019年,全球心血管疾病患者人数为5.23亿人,而心血管疾病导致的死亡人数达到1860万人。
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引用次数: 4
期刊
Reumatologia
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