系统性红斑狼疮患者超声心动图改变与抗心磷脂抗体的关系

Echocardiographic changes and anticardiolipin antibodies in patients with systemic lupus erythematosus

目的:检测SLE患者抗心磷脂抗体(aCL)的阳性率,分析SLE患者超声心动图下心瓣膜损害与aCL的关系。方法:90例SLE患者接受超声心动图检查,其中43例行ELISA法aCL的检测。根据有无心脏瓣膜损害将此43例患者分为有瓣膜损害组和无瓣膜损害组。统计分析两组间血清aCL差异。结果:90例SLE患者超声心动图异常者占53.33%,其中瓣膜病变和心包积液者最常见,分别占总数的38.89%和34.44%。43例SLE患者aCL的阳性率为32.56%,有瓣膜损害组的aCL阳性率52.94%明显高于无瓣膜损害组(19.23%,P<0.05)。结论:系统性红斑狼疮患者的超声心动图改变有较高的发生率,以瓣膜损害和心包积液为主;aCL可能与系统性红斑狼疮患者心瓣膜损害有关。

Objective To analyze the echocardiographic abnormalities and the prevalence of anticardiolipin antibodies （aCL） in systemic lupus erythematosus （SLE） patients and to evaluate the relationship between aCL and cardiac valvular abnormalities in SLE patients. Methods Ninety SLE patients were performed M-mode, 2-dimensional and Doppler echocardiography and aCL IgG and IgM were measured by an enzyme-linked immunosorbent assay （ELISA）. According to the abnormalities in the echocardiography, the patients were assigned into valvular abnormality group and non-valvular abnormality group. Chi-square method was used to compare the difference of aCL prevalence between the two groups. Results The prevalence of echocardiographic abnormalities was 53.33 % , and valvular abnormality （38.89%） and pericardial effusion （34.44%） presented most frequently. The aCL prevalence was 32.56% in the 43 SLE patients. The prevalence of aCL in the valvular abnormality group was significantly higher than that in non-valvular abnormality group （52. 94% vs 19.23%, P 〈 0.05 ）. Conclusion The incidence of echocardiographic abnormalities is high in SLE patients, most often in valves and pericardium. The aCL is probably related to valvular damage in SLE patients.