avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2020-10-4-272-280avk-1072Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESСиндром холестериновой атероэмболии: современное состоя ние проблемыCholesterol Atheroembolism Syndrome: Current State of the ProblemМихайловаЗ. Д.MikhailovaZ. D.

Нижний Новгород

N. Novgorod

https://orcid.org/0000-0002-0926-6038КлимкинП. Ф.KlimkinP. F.

Нижний Новгород

N. Novgorod

climckin2009@yandex.ruГосударственное бюджетное учреждение здравоохранения Нижегородской области «Городская клиническая больница № 38»РоссияMunicipal Clinical hospital № 38Russian FederationГосударственное бюджетное учреждение здравоохранения Нижегородской области «Городская клиническая больница № 5»РоссияMunicipal Clinical hospital № 5Russian Federation202029072020104272280Copyright © Михайлова З.Д., Климкин П.Ф., 20202020Михайлова З.Д., Климкин П.Ф.Mikhailova z.D., Klimkin P.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1072

Синдром холестериновой атероэмболии — это системный патологический процесс, обусловленный эмболизацией мелких артерий кристаллами холестерина, который может развиваться спонтанно, являтьс я результатом внутрисосудистых оперативных вмешательств и/или применения антикоагулянтов. Эмболизация кристаллами холестерина приводит к ишемическому и воспалительному повреждению органа. Клиническая картина вариабельна, мишенями могут быть различные органы, но преимущественно поражается кожа и почки. Специфические клинические и лабораторные признаки отсутствуют. Золотым стандартом диагностики синдрома холестериновой атероэмболии является биопсия тканей. Лечение основано на коррекции классических сердечно-сосудистых факторов риска, применении статинов. Отказ от антикоагулянтов и тромболитиков следует рассматривать с точки зрения баланса пользы и риска. Данные по использованию кортикостероидов, цитостатиков и колхицина носят противоречивый характер. Перспективным направлением является использование моноклональных антител антагонистов интерлейкина — 1ß.

Cholesterol atheroembolism syndrome is a systemic pathological process caused by the embolization of small arteries with cholesterol crystals, which can develop spontaneously, and it is the result of intravascular surgery and / or the use of anticoagulants. Embolization cholesterol crystals leads to ischemic and inflammatory organ damage. The clinical picture is variable, various organs can be targets, but skin and kidneys are mainly affected. Specific clinical and laboratory signs aren’t. Tissue biopsy is the gold standard for diagnosis cholesterol atheroembolism syndrome. The treatment is based on the correction of classical cardiovascular risk factors, the use of statins. In terms of benefit and risk failure from anticoagulants and thrombolytics should be considered. Studies on the use of corticosteroids, cytostatic, and colchicine have conflicting results. The use of monoclonal antibodies of IL-1 antagonists is a perspective direction.

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The authors declare that there are no conflicts of interest present.