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Современная ревматология

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Молекулярные аспекты управления ревматической болью

https://doi.org/10.14412/1996-7012-2020-1-93-100

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Аннотация

Ревматические заболевания (РЗ), в том числе остеоартрит и ревматоидный артрит, – это неинфекционные медленно прогрессирующие неизлечимые воспалительные заболевания, приводящие к длительной инвалидности вследствие поражения опорно-двигательного аппарата. Боль является доминирующим симптомом на любой стадии этих заболеваний, непосредственно связана с функционированием суставов и определяет качество жизни больных. При этом, несмотря на значительные успехи в исследовании роли воспаления и регуляции аутоиммунных процессов, патогенетические механизмы развития и сохранения боли при РЗ малоизученны. В развитии ревматической боли участвуют ноцицептивные механизмы, обусловленные воспалением и/или нарушением структуры сустава. Кроме того, ревматическая боль также связана с нарушениями при передаче сигналов нервной системой и психологическими проблемами больных.

На современном этапе лечение боли включает нефармакологические методы, а также использование некоторых фармакологических средств, в частности опиоидов и наркотических средств. Однако, несмотря на значительные успехи в создании препаратов, купирующих боль, в настоящее время у значительной части больных РЗ боль сохраняется и после терапии. При создании новых препаратов для лечения боли необходимо учитывать молекулярные механизмы формирования боли при РЗ. В данном обзоре рассмотрены особенности ее проявлений, молекулярные маркеры и механизмы боли на разных стадиях заболевания у больных двумя наиболее распространенными РЗ – ревматоидным артритом и остеоартритом. 

Об авторах

Е. В. Четина
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
115522, Москва, Каширское шоссе, 34А


Е. П. Шарапова
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
115522, Москва, Каширское шоссе, 34А


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Для цитирования:


Четина Е.В., Шарапова Е.П. Молекулярные аспекты управления ревматической болью. Современная ревматология. 2020;14(1):93-100. https://doi.org/10.14412/1996-7012-2020-1-93-100

For citation:


Chetina E.V., Sharapova E.P. Rheumatic pain management: molecular aspects. Modern Rheumatology Journal. 2020;14(1):93-100. (In Russ.) https://doi.org/10.14412/1996-7012-2020-1-93-100

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ISSN 1996-7012 (Print)
ISSN 2310-158X (Online)