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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rsp</journal-id><journal-title-group><journal-title xml:lang="ru">Научно-практическая ревматология</journal-title><trans-title-group xml:lang="en"><trans-title>Rheumatology Science and Practice</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1995-4484</issn><issn pub-type="epub">1995-4492</issn><publisher><publisher-name>IMA-PRESS, LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.47360/1995-4484-2021-708-714</article-id><article-id custom-type="elpub" pub-id-type="custom">rsp-3105</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL RESEARCH</subject></subj-group></article-categories><title-group><article-title>Влияние терапии на субклинический атеросклероз сонных артерий у пациентов с болезнью депонирования кристаллов пирофосфатов кальция и остеоартритом (пилотное исследование)</article-title><trans-title-group xml:lang="en"><trans-title>The effect of therapy on subclinical atherosclerosis of the carotid arteries in patients with calcium pyrophosphate crystal deposition disease and osteoarthritis (pilot study)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1191-5831</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Елисеев</surname><given-names>М. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Eliseev</surname><given-names>M. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Елисеев Максим Сергеевич,</p><p>115522, Москва, Каширское шоссе, 34а.</p></bio><bio xml:lang="en"><p>Maxim S. Eliseev.</p><p>163069, Troitsky avenue, 51.</p></bio><email xlink:type="simple">elicmax@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5394-7869</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Желябина</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhelyabina</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а.</p></bio><bio xml:lang="en"><p>Olga V. Zhelyabina.</p><p>163069, Troitsky avenue, 51.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8777-7597</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чикина</surname><given-names>М. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Chikina</surname><given-names>M. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а.</p></bio><bio xml:lang="en"><p>Maria N. Chikina.</p><p>163069, Troitsky avenue, 51.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1729-4610</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Маркелова</surname><given-names>Е. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Markelova</surname><given-names>E. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а.</p></bio><bio xml:lang="en"><p>Evgenia I. Markelova.</p><p>163069, Troitsky avenue, 51.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1003-2087</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кириллова</surname><given-names>И. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Kirillova</surname><given-names>I. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а.</p></bio><bio xml:lang="en"><p>Irina G. Kirillova.</p><p>163069, Troitsky avenue, 51.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3052-7466</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Корсакова</surname><given-names>Ю. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Korsakova</surname><given-names>Yu. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а.</p></bio><bio xml:lang="en"><p>Yulia O. Korsakova.</p><p>163069, Troitsky avenue, 51.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3498-7942</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кобрисева</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kobriseva</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а.</p></bio><bio xml:lang="en"><p>Alexandra A. Kobriseva.</p><p>163069, Troitsky avenue, 51.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Научно-исследовательский институт ревматологии им. В.А. Насоновой</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Northern State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>27</day><month>12</month><year>2021</year></pub-date><volume>59</volume><issue>6</issue><fpage>708</fpage><lpage>714</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Елисеев М.С., Желябина О.В., Чикина М.Н., Маркелова Е.И., Кириллова И.Г., Корсакова Ю.О., Кобрисева А.А., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Елисеев М.С., Желябина О.В., Чикина М.Н., Маркелова Е.И., Кириллова И.Г., Корсакова Ю.О., Кобрисева А.А.</copyright-holder><copyright-holder xml:lang="en">Eliseev M.S., Zhelyabina O.V., Chikina M.N., Markelova E.I., Kirillova I.G., Korsakova Y.O., Kobriseva A.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://rsp.mediar-press.net/rsp/article/view/3105">https://rsp.mediar-press.net/rsp/article/view/3105</self-uri><abstract><p>Одним из факторов прогрессирования атеросклероза при болезни депонирования кристаллов пирофосфата кальция (БДПК) является эндотелиальная дисфункция, связанная с хроническим микрокристаллическим воспалением.</p><p>Цель исследования — оценка динамики развития атеросклероза на основании изменений толщины комплекса «интима — медиа» (ТКИМ) сонных артерий (СА) у пациентов с БДПК, длительно получающих противовоспалительную терапию (колхицин, метотрексат, гидроксихлорохин).</p><sec><title>Материалы и методы</title><p>Материалы и методы. Включено по 26 пациентов старше 18 лет с БДПК и остеоартритом (ОА). Критерии исключения: возраст &gt;65 лет; наличие сердечно-сосудистых заболеваний. Всем определяли липидный спектр крови, уровень С-реактивного белка (СРБ), антропометрические параметры, проводили ультразвуковую допплерографию (УЗДГ) СА. Пациенты наблюдались не менее 6 месяцев. На 1-м визите оценивалась ТКИМ СА, далее пациентам с БДПК на усмотрение лечащего врача назначался метотрексат в дозе 15 мг/нед., гидроксихлорохин 200 мг 1 раз в сутки или колхицин 0,5 мг 2 раза в сутки. Они могли также принимать нестероидные противовоспалительные препараты при наличии болей. Всем пациентам рассчитан индекс SCORE.</p></sec><sec><title>Результаты</title><p>Результаты. Исходные значения ТКИМ у пациентов с БДПК и ОА существенно не различались. ТКИМ&gt;0,9 мм выявлена у 11 из 22 (50%) пациентов с БДПК и у 8 из 19 (42%) пациентов с ОА (р=0,39). За время наблюдения отмечалось уменьшение количества пациентов с БДПК, имеющих ТКИМ&gt;0,9 мм, с 50 до 18%. При этом у 8 из них ТКИМ&gt;0,9 мм сочеталась с уровнем СРБ &gt;0,2 мг/л. У 14 из 22 (64%) пациентов с БДПК отмечалось уменьшение, у 2 (9%) — увеличение среднего значения ТКИМ; в 5 случаях оно не изменилось. У 7 из 11 пациентов с БДПК, исходно имевших ТКИМ&gt;0,9 мм, после 6 мес. лечения она была меньше указанного значения, у 5 из них отмечалось снижение сывороточного уровня СРБ &lt;2 мг/л. У пациентов с БДПК уровень СРБ сыворотки статистически значимо снизился, у пациентов с ОА — не изменился. У 9 из 19 (47%) пациентов с ОА за время наблюдения отмечалось увеличение средних показателей ТКИМ, у остальных они не менялись. Снижение средних показателей ТКИМ отмечалось у 5 из 6 (83%) пациентов, получавших гидроксихлорохин, у 6 из 9 (67%) принимавших колхицин, и у 4 из 7 (57%) на фоне лечения метотрексатом.</p><p>Уменьшение начальных признаков атеросклероза, отмечавшееся по данным УЗДГ сонных артерий у пациентов с БДПК, получавших колхицин, метотрексат и гидроксихлорохин, может быть обусловлено влиянием этих препаратов на хроническое воспаление.</p></sec></abstract><trans-abstract xml:lang="en"><p>Endothelial dysfunction associated with chronic microcrystalline inflammation plays a role in the progression of atherosclerosis in calcium pyrophosphate crystal deposition diseases (CPPD).</p><p>The aim of the study was to assess the dynamics of the development of atherosclerosis based on changes in the thickness of the intima-media complex (ICIM) of the carotid arteries (CA) in patients with CPPD receiving long-term anti-inflammatory therapy (colchicine, methotrexate, hydroxychloroquine).</p><sec><title>Materials and methods</title><p>Materials and methods. 26 patients with CPPD and 26 patients with osteoarthritis aged over 18 years old were included. Exclusion criteria: age &gt;65 years; presence of cardiovascular diseases. The blood lipid spectrum, hs-CRP level, anthropometric parameters were determined for all, and Doppler ultrasound ultrasonography of the carotid arteries (CA) was performed. Patients were followed up for not &lt;6 months, assessed ICIM CA at 1 visit, then patients with CPPD, at the discretion of the attending physician, were prescribed methotrexate at a dose of 15 mg per week, hydroxychloroquine 200 mg 1 time per day or colchicine 0.5 mg 2 times a day. Patients could take NSAIDs if they were in pain. The SCORE index has been calculated for everyone.</p></sec><sec><title>Results</title><p>Results. Initially, ICIM values did not differ in patients with CPPD and OA. Initially, ICIM&gt;0.9 mm were detected in 11 of 22 (50%) patients with CPPD and in OA in 8 of 19 (42%) (p=0.39). In dynamics, patients with CPPD revealed a decrease in the number of patients with ICIM&gt;0.9 mm from 42 to 18%. At the same time, in 8 patients with CPPD, ICIM&gt;0.9 mm was combined with a CRP level &gt;0.2 mg/l. Out of 22 patients with CPPD, 14 (64%) patients showed a decrease in the mean values of ICIM, in 2 (9%) patients - an increase, in 5 patients the mean values of ICIM did not change. After 6 months of therapy, out of 11 patients with CPPD with ICIM &gt;0.9 mm, after 6 months of therapy, in 7 cases there was a decrease in the indicator less than the specified value, in 5 of them a decrease in serum CRP level &lt;2 mg/l was recorded. In patients with CPPD, the serum CRP level significantly decreased; in patients with OA, it did not change. Out of 19 patients with OA, 9 (47%) patients showed an increase in the mean ICIM over time, while the rest did not change. In those treated with hydroxychloroquine, a decrease in the mean ICIM parameters was observed in 5 out of 6 (83%) patients, colchicine - in 6 out of 9 (67%) patients, methotrexate - in 4 out of 7 (57%) patients.</p><p>With CPPD, the result of therapy with colchicine, methotrexate and hydroxychloroquine in relation to the development of the initial signs of atherosclerosis according to Doppler ultrasound ultrasonography of CA can be realized based on the presence of chronic inflammation.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>атеросклероз</kwd><kwd>сердечно-сосудистая смертность</kwd><kwd>толщина комплекса «интима — медиа»</kwd><kwd>противовоспалительная терапия</kwd><kwd>колхицин</kwd><kwd>метотрексат</kwd><kwd>гидроксихлорохин</kwd></kwd-group><kwd-group xml:lang="en"><kwd>atherosclerosis</kwd><kwd>cardiovascular mortality</kwd><kwd>intima-media complex thickness</kwd><kwd>anti-inflammatory therapy</kwd><kwd>colchicine</kwd><kwd>methotrexate</kwd><kwd>hydroxychloroquine</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование проводилось в рамках прикладного научного исследования «Оптимизация методов симптоматической противовоспалительной терапии у пациентов с микрокристаллическими артритами (подагра, болезнь депонирования кристаллов пирофосфата кальция)» (№ 2020-397-007).</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. 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