心血管疾病在银屑病患者中的临床应用:1例报告。欧亚心脏杂志

O. A. Kuzmina, O. Mironova, V. V. Fomin
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引用次数: 1

摘要

牛皮癣是一种由基因决定的多因素疾病,影响约2%的人口。根据这种疾病的现代概念,合并症的发病率很高,特别是那些与心血管系统损伤有关的疾病。这篇文章提出了一个临床病例严重播散寻常型银屑病,进行性阶段,混合形式的病人有非常高的心血管风险。本病例的独特之处在于牛皮癣合并了严重高血压、肥胖、血脂异常、2型糖尿病、高尿酸血症等合并症。主要临床表现为患者皮肤广泛病变,体力活动时胸骨后不适发作,以及血压数值不稳定(最大升高至180/100 mm Hg)。作为皮肤门诊住院治疗的一部分,患者接受了局部软膏治疗,使用糖皮质激素软膏、含有水杨酸的软膏、PUVA治疗,结果皮肤过程显示出积极的动态变化,病变消退了90-100%,结果是残留的色素沉着,没有发现新的病变。在治疗科住院期间,选择降压、降脂、降尿、降糖的最佳治疗方案,使患者的病情得到改善,血压稳定在130-140/70 mm Hg。因此,银屑病患者在临床实践中需要仔细评估心血管风险。多学科的方法不仅可以提高患者的生活质量,减少主要心血管事件的可能性,还可以延长预期寿命并降低死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiovascular diseases in patients with psoriasis in clinical practice: case report. Eurasian heart journal
Psoriasis is a genetically determined multifactorial disease that affects about 2% of the population. According to modern concepts of this disease, the level of comorbid diseases, especially those associated with damage to the cardiovascular system, is high. This article presents a clinical case of severe disseminated psoriasis vulgaris, progressive stage, mixed form in a patient with a very high cardiovascular risk. The uniqueness of this clinical case lies in the combined course of psoriasis and such comorbid diseases as: severe hypertension, obesity, dyslipidemia, type 2 diabetes mellitus (DM), hyperuricemia. The main clinical manifestations were the presence of widespread lesions on the patient’s skin, episodes of discomfort behind the sternum during physical activity, as well as destabilization of blood pressure numbers (maximum rise to 180/100 mm Hg). As part of the hospitalization in the skin clinic, the patient underwent topical ointment therapy with the use of glucocorticoid ointments, ointments containing salicylic acid, PUVA therapy, as a result of which the skin process showed positive dynamics with regression of lesions by 90-100% with an outcome in residual hyperpigmentation, no new lesions were noted. During hospitalization to a therapy department, the optimal antihypertensive, lipid-lowering, uricosuric, hypoglycemic therapy was selected, as a result of which it was possible to achieve an improvement in the patient’s condition, stabilization of blood pressure at the level of 130-140/70 mm Hg. So patients with psoriasis require careful assessment of cardiovascular risk in clinical practice. A multidisciplinary approach will not only improve the quality of life of patients, reduce the likelihood of major cardiovascular events, but also increase life expectancy and reduce mortality.
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