Терапевтический архив (May 2003)
Microcirculatory disorders in systemic lupus erythematosus
Abstract
Aim. To examine microcirculation in patients with systemic lupus erythematosus (SLE) showing clinical signs which may deteriorate hemodynamic indices: arterial hypertension (AH), atherosclerosis, antiphospholipid syndrome (APS). Material and methods. Microcirculatory changes were studied in 63 patients with SLE using biomicroscopy of bulbar conjunctival vessels (Zeiss slit-lamp, 32 times magnification). The following conjunctival indices were estimated : general (GCI), vascular (VCI), intravascular (IVCI), extravascular or perivascular. Results. Microcirculatory changes in SLE patients covered disturbances of microvascular architectonics, microvascular blood flow. VCI, IVCI, GCI were significantly higher than in control subjects : 6.16 + 0.31, 3.69 + 0.36 and 9.87 + 0.57 scores vs 3.20 ± 0.50; 120 ± 0.20 and 4.20 ± 0.50 scores, respectively. The degree of structural changes in the vessels depended on the disease duration while intravascular changes depended on the activity of lupus process. In patients with AH and atherosclerosis microcirculatory disturbances were similar and related to vascular architectonics. In APS there were marked intravascular disorders (IVCI was 7.50 ± 0.59 scores, GCI was 16.13 ± 1.41 scores). Conclusion. In SLEpatients with AH and/or atherosclerosis microcirculatory changes involved primarily structure of the vascular wall and may be brought about by compensatory-adaptive mechanisms of the microcirculatory bed in high hemodynamic load. Intravascular microcirculatory changes were most pronounced, first of all as sludge-phenomenon, in APS and high SLE activity.
