[Microcirculatory disorders in systemic lupus erythematosus]. / Mikrotsirkuliatornye narusheniia pri sistemnoi krasnoi volchanke.

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 SLE patients 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.

[Renal hemodynamics in patients with systemic lupus erythematosus as shown by renal scintigraphy]. / Pochechnaia gemodinamika u bol'nykh sistemnoi krasnoi volchankoi po dannym stsintigrafii pochek.

Dynamic scintigraphy (DS) provides qualitative and quantitative assessment of renal circulation in patients with different diseases. Few data are still available on application of DS of the kidneys in patients with systemic lupus erythematosus (SLE). Renal hemodynamics studies with DS are not described in SLE patients with disturbances of renal metabolism and/or antiphospholipid syndrome (APS). We examined renal hemodynamics in SLE patients with renal disease, arterial hypertension, impaired lipid metabolism, APS. We examined 65 patients with confirmed diagnosis of SLE with 99mTc DS and estimated effective renal blood flow. The latter was damaged more in SLE patients with symptoms of renal disorders. Arterial hypertension deteriorated renal hemodynamics. In hypertensive patients with affected kidneys angionephroscintigraphic parameters changed most significantly. Renal hemodynamics in disturbed lipid metabolism was worse than in normal one but the difference was not significant. Angionephroscintigraphy findings were worse in patients with APS than in those with renal lesion and arterial hypertension but free of APS.

[Echocardiographic functional assessment of the heart and lipid metabolism in patients with systemic scleroderma and systemic lupus erythematosus]. / Funktsional'naia otsenka sostoianiia serdtsa po dannym ékhokardiografii i sostoianiia lipidnogo obmena u bol'nykh sistemnoi sklerodermiei i sistemnoi krasnoi volchankoi.

AIM: To characterize structural-functional state of the heart by means of uni-, two-dimentional and doppler echocardiography in impulse regimen; to evaluate lipid metabolism in patients with scleroderma systematica (SS) and systemic lupus erythematosus (SLE). MATERIAL AND METHODS: The examination of 35 SS and 38 SLE patients included clinical examination, echocardioscopy with doppler cardiography, measurements of serum concentrations of total cholesterol, triglycerides, low and high density lipoproteins, atherogenic index. RESULTS: In SS patients central hemodynamics reflects hyperdynamics. In intact contractility, diastolic function of the ventricles is impaired. Elevated atherogenicity of the serum was found in both the groups. CONCLUSION: According to echocardiography SLE and SS are associated with changes in both intracardiac and central hemodynamics. High atherogenicity of the serum may appear an additional factor of risk of hemodynamic disturbances.

[Characteristics of cardiac and nervous system impairment in patients with systemic lupus erythematosus from regions with various levels of environmental pollution]. / Osobennosti porazheniia serdtsa i nervnoi sistemy u bol'nykh sistemnoi krasnoi volchankoi, prozhivaiushchikh v raionakh s zagriazneniem vneshnei sredy razlichnoi stepeni.

AIM: To characterize clinical features of systemic lupus erythematosus (SLE) in persons living under various environmental pollution. MATERIAL AND METHOD: Three groups of SLE patients living in the Orenburg region were examined: those exposed to intensive production pollution (n = 35 patients), exposed to mild pollution (n = 15), unexposed to production pollution (n = 25 patients). The pollution intensity was assessed by total aerogenic, water and soil pollution rates. RESULTS: The hair from 69 patients contained 24 chemical elements. More severe clinical symptoms of SLE were registered in patients living in conditions of intensive production pollution. These symptoms' severity directly correlated with the level of heavy metals in the hair of SLE patients and inversely correlated with hair levels of essential chemical elements. CONCLUSION: Chemical pollutants directly impair organs and tissues of SLE patients and indirectly do this via damaged immune system.