系统性红斑狼疮心脏受累的诊治进展

Advances in Diagnosis and Management of Cardiac Involvement in Systemic Lupus Erythematosus

系统性红斑狼疮(SLE)是最常见的系统性自身免疫性疾病之一,合并心脏受累的发生率高达50%以上,而心脏受累常常是SLE患者预后不良和死亡的主要原因。其发生机制包括:心脏和血管的自身免疫性炎症,T细胞激活释放大量细胞因子,长期使用糖皮质激素加速冠状动脉硬化等,上述因素共同作用导致心脏病变和早发的冠状动脉粥样硬化。心脏各层均可受累,心包炎最常见,约见于60%的SLE患者,心肌病变和早发冠状动脉粥样硬化也比较常见,是SLE的常见死因。因此,应常规对SLE的患者进行心脏受累的筛查,早期诊断,并尽早积极治疗可改善SLE患者的预后。

Systemic lupus erythematosus（SLE） is one of the most frequent connective tissue diseases.The prevalence of cardiac involvement in SLE exceeds more than 50 percent,typically with an unfavorable prognosis and death.The autoimmune inflammation of the heart and coronary artery,mass cytokines released by activated T lymphocytes,and long-term treatment with glucocorticoids may all lead to heart disease and praecox coronary atherosclerosis in SLE patients.Pericarditis,endocarditis,myocardiopathy,coronary atherosclerosis and arrhythmia are frequent in SLE patients.So routine screening of cardiac involvement should be done for SLE patients.Early diagnosis and positive management may improve the prognosis of SLE patients with cardiac involvement.This review is to expound the advances of the diagnosis and management of cardiac involvement in SLE.