Wpływ steroidoterapii na układ sercowo-naczyniowy

• Authors: Anna Otlewska , Grzegorz Szpotowicz , Paweł Hackemer

Title variants

EN

The effects of steroid therapy on the cardiovascular system

• Languages of publication: PL EN

Abstracts

PL

Glikokortykosteroidy są powszechnie stosowane w terapii wielu chorób, gdzie wykorzystywane jest ich działanie przeciwzapalne, przeciwproliferacyjne i immunosupresyjne. Często podawane są długotrwale, co wiąże się z ryzykiem wystąpienia działań niepożądanych ze strony różnych układów. W niniejszej pracy zwrócono uwagę przede wszystkim na wpływ steroidoterapii na pojawienie się chorób serca i naczyń, ponieważ długotrwała terapia steroidami zwiększa ryzyko zgonu z przyczyn sercowo-naczyniowych. Stopień ryzyka wystąpienia powikłań zależy od wielkości stosowanej dawki oraz czasu prowadzonej terapii. Nie znika on nawet wtedy, gdy steroidy stosowane są miejscowo. Według danych z literatury przyjmowanie glikokortykosteroidów może przyczyniać się do rozwoju nadciśnienia tętniczego, niedokrwienia mięśnia sercowego, niewydolności serca, a według niektórych badań także do udarów. Stosowanie steroidoterapii może prowadzić do rozwoju zaburzeń będących elementami zespołu metabolicznego. W patogenezie uwzględnia się wpływ glikokortykosteroidów na układ renina–angiotensyna–aldosteron, układ autonomiczny, pobudzanie receptora mineralokortykosteroidowego, wpływ na syntezę czynników regulujących szerokość naczyń krwionośnych. Innymi zaburzeniami, które w przebiegu tej terapii mogą się rozwijać, są: osteoporoza, miopatia, zaburzenia elektrolitowe i metaboliczne. Trudno jednak określić, w jakim stopniu sama terapia wpływa na wystąpienie powikłań, a w jakim choroba, z której powodu stosowane są te leki. Warto również pamiętać o negatywnym wpływie na organizm steroidów anabolicznych, których przyjmowanie zazwyczaj nie jest elementem terapii innego schorzenia.

EN

Glucocorticoids are widely used as anti-inflammatory, antiproliferative and immunosuppressive agents in many diseases. Their use is often long-term, which is associated with the risk of adverse effects from various systems. In this paper, we pay particular attention to the effects of steroid therapy on cardiovascular diseases as long-term steroid therapy increases the risk of cardiovascular death. The risk of complications depends on the dose and therapy duration. Complications may also occur when steroids are used locally. According to literature data, glucocorticoids may contribute to the development of hypertension, myocardial ischaemia, heart failure and, according to some studies, stroke. The use of steroid therapy can lead to the development of disorders that are part of the metabolic syndrome. The pathogenesis includes the effects of glucocorticoids on the renin–angiotensin–aldosterone system, the autonomic system, stimulation of the mineralocorticoid receptor, and effects on the synthesis of factors regulating the width of blood vessels. Other disorders that may develop in the course of this therapy include osteoporosis, myopathy, electrolyte and metabolic disorders. However, it is difficult to determine to what extent the complications are caused by the therapy itself and to what extent by the treated disease. It is also worth noting about the negative impact of anabolic steroids, the use of which is usually not a part of therapy.

Keywords

EN

choroby sercowo-naczyniowe; glikokortykosteroidy; steroidoterapia; zespół Cushinga

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Pediatria i Medycyna Rodzinna
• Year: 2018
• Volume: 14
• Issue: 3
• Pages: 267–270

Contributors

author

Anna Otlewska

• Katedra i Zakład Fizjologii, Uniwersytet Medyczny we Wrocławiu, Wrocław, Polska. Kierownik Katedry: prof. dr hab. n. med. Beata Ponikowska

author

Grzegorz Szpotowicz

• Zakład Anatomii Prawidłowej, Uniwersytet Medyczny we Wrocławiu, Wrocław, Polska. Kierownik Zakładu (p.o.): dr n. med. Zygmunt Domagała

author

Paweł Hackemer

• Klinika Urologii i Onkologii Urologicznej, Uniwersytecki Szpital Kliniczny we Wrocławiu, Wrocław, Polska. Kierownik Kliniki: prof. dr hab. n. med. Romuald Zdrojowy

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• Document Type: article