系统性红斑狼疮患者循环系统脏器合并症的性质及发生频率特征取决于性别、年龄和病程

L. Kobak, O. Abrahamovych, U. Abrahamovych, R. Ivanochko, V. Chemes
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Prior to performing the study all patients signed the voluntary consent to participate in accordance with the requirements of Helsinki Declaration of Human Rights, the Council of Europe Convention on Human Rights and Biomedicine. The cohort under investigation included 112 patients with diagnosed SLE of different severity with preliminary stratification as follows: females 89.29 %, patients of working age (57.14 % – young and 39.29 % – middle aged), unemployed (58.04 %), III disability group patients (45.54 %), city residents (62.50 %). According to the results of the disease duration assessment, a significant number of patients with SLE and circulatory system organs comorbid lesions have been ill for 1–5 years (36.61 %) and more than 10 years (38.39 %). All of them were patients of the rheumatology department of the Communal Non-Profit Enterprise of the Lviv Regional Council “Lviv Regional Clinical Hospital” from 2016 to 2021.The research was carried out in several stages, during which the nature and frequency of the circulatory system comorbid lesions with respect to gender, age and disease duration were estimated. Results. While completing the study, almost half of patients with SLE were diagnosed with Raynaud’s syndrome, mitral valve insufficiency and atherosclerosis, about 1/3 – with myocarditis, retinal angiopathy, symptomatic arterial hypertension and livedo reticularis. The varicose veins of the lower extremities, hypertensive disease, diffuse cardiosclerosis, tricuspid valve insufficiency, vein thrombosis, post-thrombophlebitis syndrome, aortic valve insufficiency, capillaritis, pulmonary hypertension, coronary artery disease (CAD) including stable angina pectoris, cardiomyopathy and post-infarction cardiosclerosis were found with the decreasing frequency. Raynaud’s syndrome was significantly more often diagnosed in females and young people; retinal angiopathy, livedo reticularis and symptomatic arterial hypertension – in females and those patients whose SLE lasted for more than 10 years; myocarditis, varicose veins of the lower extremities – in males; capillaritis – in patients with the shortest duration of SLE; atherosclerosis and mitral valve insufficiency – in elderly patients and patients with SLE lasting for 6–10 years; vein thrombosis and stable angina – in elderly patients and those with SLE lasting for more than 10 years; hypertensive disease, diffuse cardiosclerosis, aortic valve insufficiency, post-infarction cardiosclerosis were the most characteristic for the elderly patients with SLE. Conclusions. In patients with systemic lupus erythematosus, a number of circulatory system organs comorbid lesions were found. 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引用次数: 1

摘要

介绍。系统性红斑狼疮(SLE)是一种具有多种临床表现和不可预测病程的疾病。它通常持续几个月或几年,交替缓解和恶化。多个器官可同时受到不同程度的严重影响,导致与治疗和疾病相关的合并症,包括循环系统疾病,这是SLE患者死亡的主要原因之一。研究的目的。了解系统性红斑狼疮患者循环系统脏器合并症病变的性质和频率,并根据性别、年龄和病程特征对其进行定性。材料和方法。在进行研究之前,所有患者根据《赫尔辛基人权宣言》、《欧洲委员会人权与生物医学公约》的要求签署了自愿同意。本研究纳入112例诊断为不同严重程度SLE患者,初步分层如下:女性89.29%,工作年龄患者(青年57.14%,中年39.29%),无业(58.04%),III残疾组患者(45.54%),城市居民(62.50%)。病程评估结果显示,大量SLE合并循环系统脏器合并症患者患病时间为1-5年(36.61%)和10年以上(38.39%)。所有患者都是2016年至2021年在利沃夫地区理事会公共非营利企业“利沃夫地区临床医院”风湿病科就诊的患者。研究分几个阶段进行,在此期间,循环系统共病病变的性质和频率与性别、年龄和疾病持续时间有关。结果。在研究完成时,几乎一半的SLE患者被诊断为雷诺综合征、二尖瓣功能不全和动脉粥样硬化,约1/3的SLE患者被诊断为心肌炎、视网膜血管病变、症状性动脉高血压和网状动脉炎。下肢静脉曲张、高血压疾病、弥漫性心脏硬化、三尖瓣不全、静脉血栓形成、血栓后静脉炎综合征、主动脉瓣不全、毛细血管炎、肺动脉高压、冠状动脉疾病(CAD)包括稳定型心绞痛、心肌病和梗死后心脏硬化的发生率呈下降趋势。雷诺综合征在女性和年轻人中更为常见;视网膜血管病变、网状增生和症状性动脉高血压-女性和SLE持续10年以上的患者;心肌炎、下肢静脉曲张——男性;毛细血管炎——发生在病程最短的SLE患者;动脉粥样硬化和二尖瓣功能不全-老年患者和持续6-10年的SLE患者;静脉血栓和稳定型心绞痛——在老年患者和持续10年以上的SLE患者中;高血压病、弥漫性心脏硬化、主动脉瓣功能不全、梗死后心脏硬化是老年SLE患者的最典型特征。结论。在系统性红斑狼疮患者中,发现许多循环系统器官合并症病变。通过对其性质和发生频率的研究,并根据性别、年龄和病程对其进行定性分析,得出系统性红斑狼疮患者循环系统疾病筛查检查应考虑的特点,并对其进行综合护理,以提高患者的生活质量。考虑到这一点,系统性红斑狼疮需要进一步的详细研究。
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Circulatory System Organs Comorbid Lesions in Patients with Systemic Lupus Erythematosus: Nature and Frequency; Characteristics Depending on Gender, Age and Disease Duration
Introduction. Systemic lupus erythematosus (SLE) is a disease with numerous clinical manifestations and an unpredictable course. It often lasts for several months or years, with alternating remissions and exacerbations. Multiple organs can be affected simultaneously with varying degrees of severity, resulting in treatment- and disease-related comorbidities, including circulatory system diseases, which are one of the leading causes of death of SLE patients. The aim of the study. To find out the nature and frequency of the circulatory system organs comorbid lesions in patients with systemic lupus erythematosus, to characterize them depending on the gender, age and the disease duration. Materials and methods. Prior to performing the study all patients signed the voluntary consent to participate in accordance with the requirements of Helsinki Declaration of Human Rights, the Council of Europe Convention on Human Rights and Biomedicine. The cohort under investigation included 112 patients with diagnosed SLE of different severity with preliminary stratification as follows: females 89.29 %, patients of working age (57.14 % – young and 39.29 % – middle aged), unemployed (58.04 %), III disability group patients (45.54 %), city residents (62.50 %). According to the results of the disease duration assessment, a significant number of patients with SLE and circulatory system organs comorbid lesions have been ill for 1–5 years (36.61 %) and more than 10 years (38.39 %). All of them were patients of the rheumatology department of the Communal Non-Profit Enterprise of the Lviv Regional Council “Lviv Regional Clinical Hospital” from 2016 to 2021.The research was carried out in several stages, during which the nature and frequency of the circulatory system comorbid lesions with respect to gender, age and disease duration were estimated. Results. While completing the study, almost half of patients with SLE were diagnosed with Raynaud’s syndrome, mitral valve insufficiency and atherosclerosis, about 1/3 – with myocarditis, retinal angiopathy, symptomatic arterial hypertension and livedo reticularis. The varicose veins of the lower extremities, hypertensive disease, diffuse cardiosclerosis, tricuspid valve insufficiency, vein thrombosis, post-thrombophlebitis syndrome, aortic valve insufficiency, capillaritis, pulmonary hypertension, coronary artery disease (CAD) including stable angina pectoris, cardiomyopathy and post-infarction cardiosclerosis were found with the decreasing frequency. Raynaud’s syndrome was significantly more often diagnosed in females and young people; retinal angiopathy, livedo reticularis and symptomatic arterial hypertension – in females and those patients whose SLE lasted for more than 10 years; myocarditis, varicose veins of the lower extremities – in males; capillaritis – in patients with the shortest duration of SLE; atherosclerosis and mitral valve insufficiency – in elderly patients and patients with SLE lasting for 6–10 years; vein thrombosis and stable angina – in elderly patients and those with SLE lasting for more than 10 years; hypertensive disease, diffuse cardiosclerosis, aortic valve insufficiency, post-infarction cardiosclerosis were the most characteristic for the elderly patients with SLE. Conclusions. In patients with systemic lupus erythematosus, a number of circulatory system organs comorbid lesions were found. Having studied their nature and frequency, characterizing them depending on gender, age and the disease duration, we found out the certain features that should be taken into consideration during the screening examination of circulatory system disorders in patients with systemic lupus erythematosus and providing them the integrated care to improve their life quality. With this in mind, systemic lupus erythematosus requires further detailed study.
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