ОСОБЛИВОСТІ ПЕРЕБІГУ СИНДРОМУ РЕЙНО У ХВОРИХ НА РЕВМАТОЇДНИЙ АРТРИТ

Abstract

Often, patients with rheumatoid arthritis develop secondary Raynaud's syndrome, which is a prognostically unfavorable symptom of its course. Raynaud's syndrome is more common in patients with an existing rheumatoid factor in the blood serum. In patients with rheumatoid arthritis there is an impaired endothelium dependent vasoregulation in the shoulder artery, indicating the endothelial function disorder. In patients with rheumatoid arthritis with secondary Raynaud's syndrome, there are more pronounced signs of endothelial dysfunction, indicating a high risk of atherosclerosis and cardiovascular complications. The index of open capillaries permits to objectively assess the Raynaud's syndrome severity in patients with rheumatoid arthritis. Key words: rheumatoid arthritis, Raynaud's syndrome, endothelial dysfunction. The study is a fragment of the research project “Clinical and immunological aspects of the internal organs major diseases course and their correction”, state registration No. 0119U002040. Rheumatoid arthritis (RA) is an autoimmune disease of unknown etiology with the development of symmetrical erosive arthritis (synovitis) and a wide range of extra-articular (systemic) manifestations [9]. This is the most common and disabling connective tissue disease (affects about 1% of the world and 0.4% of Ukrainian population) [10]. In 58.7-72% of patients with RA, comorbid conditions such as Raynaud's syndrome (RS) and arterial hypertension, which can significantly modify the course of the disease, impair the treatment efficacy and reduce the life expectancy of patients [10]. An important pathogenetic link of RA is the microcirculation system impairment, and the microvasculature serves as the target organ in which the immune, inflammatory and metabolic mechanisms of the pathological process are implemented. Disorders in the microcirculation system are associated with the systemacity of lesions, duration of the disease, antioxidant protection disorders, endothelial dysfunction indices and reliably play a leading role in the pathogenesis of RA systemic manifestations. As of today, the endothelium is known to be the target of oxidative stress, which reduces endothelium dependent vasodilatation of blood vessels, promotes the increase of cellular processes course rate and accelerates their apoptosis.