rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2018-692-696rsp-2643Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHФакторы риска венозных тромбозов у больных ревматоидным артритомRisk factors for venous thromboses in patients with rheumatoid arthritisСатыбалдыеваМ. А.SatybaldyevaM. A.

115522 Москва, Каширское шоссе, 34А.

34A, Kashirskoe Shosse, Moscow 115522.

satybaldyevama@gmail.comРешетнякТ. М.ReshetnyakT. M.

115522 Москва, Каширское шоссе, 34А.

34A, Kashirskoe Shosse, Moscow 115522.

СередавкинаН. В.SeredavkinaN. V.

115522 Москва, Каширское шоссе, 34А.

34A, Kashirskoe Shosse, Moscow 115522.

ГлуховаС. И.GlukhovaS. I.

115522 Москва, Каширское шоссе, 34А.

34A, Kashirskoe Shosse, Moscow 115522.

НасоновЕ. Л.NasonovE. L.

115522 Москва, Каширское шоссе, 34А.

119991 Москва, ул. Трубецкая, 8, стр. 2.

34A, Kashirskoe Shosse, Moscow 115522.

8, Trubetskaya St., Build. 2, Moscow 119991.

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой».РоссияV.A. Nasonova Research Institute of Rheumatology.Russian FederationФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»; ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), кафедра ревматологии Института профессионального образования.РоссияV.A. Nasonova Research Institute of Rheumatology; Department of Rheumatology, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia.Russian Federation201821012019566692696Copyright © Сатыбалдыева М.А., Решетняк Т.М., Середавкина Н.В., Глухова С.И., Насонов Е.Л., 20192019Сатыбалдыева М.А., Решетняк Т.М., Середавкина Н.В., Глухова С.И., Насонов Е.Л.Satybaldyeva M.A., Reshetnyak T.M., Seredavkina N.V., Glukhova S.I., Nasonov E.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/2643

Цель исследования – определить факторы риска (ФР) венозных тромбоэмболических осложнений (ВТЭО) у больных ревматоидным артритом (РА).Материал и методы. В исследование включено 374 пациента (311 женщин и 63 мужчины) с достоверным диагнозом РА, соответствующих критериям ACR/EULAR 2010 г. Средний возраст пациентов составил 53,7±13,6 года, длительность заболевания – 12,1±10,7 года. Все больные находились на стационарном лечении в ФГБНУ НИИР им. В.А. Насоновой в период с 2014 по 2017 г. Выполнялось стандартное клиническое обследование периферических суставов. Активность РА определяли по DAS28. Проводилось анкетирование, включавшее вопросы по традиционным ФР ВТЭО и ФР, которые могут быть обусловлены РА и его терапией.Результаты и обсуждение. ВТЭО были зарегистрированы у 45 (12%) из 374 больных. Пациенты с ВТЭО (n=45) были включены в первую группу, без ВТЭО – во вторую (n=329). Многомерный анализ показал, что риск развития ВТЭО при РА может повышаться под влиянием следующих факторов: высокой воспалительной активности, варикозного расширения вен нижних конечностей, гиперхолестеринемии и артериальной гипертензии. Их весовые коэффициенты составляют 1,1; 2,5; 1,0; 0,9 соответственно. Согласно полученной модели (p<0,001) риск ВТЭО при РА можно прогнозировать по следующей формуле: Z = 1,1 • высокая активность РА (да = 1 / нет = 0) + 2,5 • варикозное расширение вен нижних конечностей (да = 1 / нет = 0) + 1,0 • гиперхолестеринемия (да = 1 / нет = 0) + 0,9 • артериальная гипертензия (да = 1 / нет = 0).Заключение. Увеличение риска ВТЭО у больных РА обусловливает необходимость своевременной его оценки с учетом известных ФР – как стандартных, так и обусловленных самим заболеванием. Такая оценка необходима для своевременного назначения адекватного профилактического лечения и предотвращения развития тромботических осложнений при РА.

Objective: to determine risk factors (RFs) for venous thromboembolic events (VTE) in patients with rheumatoid arthritis (RA).Subjects and methods: The investigation enrolled 374 patients (311 women and 63 men) with a reliable diagnosis of RA who met the 2010 ACR/EULAR classification criteria. The patients' mean age was 53.7±13.6 years; the disease duration was 12.1±10.7 years. All the patients were treated at the V.A. Nasonova Research Institute of Rheumatology Clinic during the period from 2014 to 2017. A standard clinical examination of the peripheral joints was performed. RA activity was measured using DAS28. A survey was made using a questionnaire including questions on traditional RFs for VTE and RFs that might be caused by RA and its therapy. Results and discussion. VTE were recorded in 45 (12%) out of the 374 patients. Group 1 included 45 patients with VTE; Group 2 consisted of 329 patients without VTE. Multidimensional analysis showed an increased risk of developing VTE in RA under the influence of the following factors: high inflammatory activity; lower extremity varicose veins; hypercholesterolemia; and hypertension. Their weighted coefficients were 1.1, 2.5, 1.0, and 0.9, respectively. According to the obtained model (p<0.001), the risk of VTE in RA can be predicted by the following formula: Z = 1.1 • high RA activity (Yes = 1/No = 0) + 2.5 • lower extremity varicose veins (Yes = 1/No = 0) + 1.0 • hypercholesterolemia (Yes = 1/No = 0) + 0.9 • hypertension (Yes = 1 / No = 0).Conclusion: The increased risk for VTE in RA patients determines the need for its timely assessment, by taking into account the known risk factors as both standard ones and those caused by the disease itself and its therapy. This risk assessment is necessary for the timely adequate treatment and prevention of thrombotic events in RA.

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The authors declare that there are no conflicts of interest present.