Modern View on the Problem of Systemic Lupus Erythematosus with and without Comorbid Lesions of the Circulatory System (Literature Review, Clinical Case Description) – Second Notice

L. Kobak, O. Abrahamovych, U. Abrahamovych, V. Chemes
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Abstract

Introduction. The prevalence and incidence of systemic lupus erythematosus (SLE) in the world is significant. In recent years, there has been a tendency of the SLE prevalence increase. Despite the undoubted progress in understanding the etiology and pathogenesis of SLE, its diagnosis and treatment, the mortality of patients, including ones at young and working age, is higher than in the general population, and circulatory system lesions are ones of its main reasons in these cases. The aim of the study. To analyze the literature, devoted to the modern view on the problem of systemic lupus erythematosus with and without comorbid lesions of the circulatory system, describe the clinical case. Materials and methods. Content analysis, method of system and comparative analysis, bibliosemantic method of studying the current scientific studies on modern principles of diagnosis and treatment of patients with SLE are used. A clinical case is described. Results. A clinical case of a 43-year-old patient S., who was hospitalized for SLE, she considers herself ill for eighteen years and she has been constantly taken outpatient and periodically inpatient treatment due to the frequent deteriorations in her general condition, clinical and laboratory parameters, is described. Based on the received results of the examinations, applying the method of determining the functional class of SLE, the patient was diagnosed with a clinical diagnosis indicating comorbid lesions of various organs and systems (skin, joints, kidneys, vessels, heart, blood system, immune system, eyes). The generally accepted basic medical complex of the patient includes drugs, taking into account the lesions to the circulatory system. The conducted complex pathogenetic treatment gave a positive result. Conclusions. In the described clinical case demonstrated the development of comorbid lesions of many organs and systems, including circulatory system, in a patient with systemic lupus erythematosus. Inclusion in the treatment complex in addition to basic and drugs for the treatment lesions of circulatory system has improved the general condition of the patient, stabilized clinical and laboratory parameters, as evidenced by a prospective study during three years. The information provided in our clinical case is consistent with the results of the literature review. Systemic lupus erythematosus needs further in-depth study due to its widespread prevalence among young and people of working age, lack of accurate knowledge about the etiology and pathogenesis of the disease, comorbid lesions of many organs and systems, including circulatory system, the development of severe and often life-threatening manifestations, the lack of clear recommendations that would predict the differentiated use of drugs taking into account comorbid syntropic lesions. Keywords: SLE, circulatory system lesions, atherosclerosis, diagnosis and treatment of SLE.
系统性红斑狼疮伴及不伴循环系统病变的现代观点(文献回顾,临床病例描述)-第二次通告
介绍。系统性红斑狼疮(SLE)的患病率和发病率在世界范围内是显著的。近年来,SLE的患病率有上升的趋势。尽管对SLE的病因、发病机制、诊断和治疗的认识取得了不容置疑的进展,但患者(包括年轻人和工作年龄)的死亡率高于一般人群,而循环系统病变是这些病例的主要原因之一。研究的目的。分析文献,致力于现代观点对系统性红斑狼疮的问题,有或没有合并症病变的循环系统,描述临床病例。材料和方法。运用内容分析法、系统与比较分析法、文献语义学方法研究目前科学研究的SLE患者现代诊疗原则。本文描述了一个临床病例。结果。43岁患者S.因SLE住院治疗,自认为患病18年,因其一般情况、临床和实验室参数频繁恶化,一直接受门诊和定期住院治疗。根据收到的检查结果,应用SLE功能分级的方法,对患者进行诊断,临床诊断为多器官和系统(皮肤、关节、肾脏、血管、心脏、血液系统、免疫系统、眼睛)共病病变。考虑到对循环系统的损害,普遍接受的病人基本医疗综合体包括药物。进行了综合致病治疗,取得了积极的效果。结论。在所描述的临床病例证明了许多器官和系统的共病病变的发展,包括循环系统,在系统性红斑狼疮患者。一项为期三年的前瞻性研究证明,除了治疗循环系统病变的基础和药物外,将患者纳入治疗方案改善了患者的一般状况,稳定了临床和实验室参数。我们的临床病例提供的信息与文献综述的结果一致。系统性红斑狼疮在年轻人和工作年龄人群中广泛流行,缺乏对该病病因和发病机制的准确认识,包括循环系统在内的许多器官和系统的共病病变,发展为严重且经常危及生命的表现,缺乏明确的建议来预测考虑共病共向病变的药物区分使用,因此需要进一步深入研究。关键词:SLE,循环系统病变,动脉粥样硬化,SLE诊断与治疗
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