系统性红斑狼疮肺动脉高压63例临床分析

Clinical analysis of pulmonary arterial hypertention in systemic lupus erythamatosus

目的探讨系统性红斑狼疮（SLE）并肺动脉高压（PAH）患者的临床特点、发病机制以及诊治方法，提高对该病的认识。方法选取本院近5年住院的SLE合并PAH的患者63例，对其临床症状、实验室指标、超声心动图特点、SLE病情活动评分等进行回顾性分析。结果该组患者抗RNP抗体阳性率较高，肺动脉压力与SLE病情活动评分无关，PAH的轻重与血液中自身抗体的出现无明显关系，PAH重者易有雷诺现象发生，而且与其他系统受累无关联，比较有无肾脏受累的患者在临床以及实验室指标的不同，没有明显差别。结论SLE患者PAH发生与其他脏器受累无关，发病隐匿，临床上应该重视SLE肺动脉压的筛查，早期发现和治疗以利于病情的控制和改善预后。

Objective To study the clinic manifestrations, mechanism, diagnosis and treatment of pulmonary arterial hypertention （PAH） in systemic lupus erythamatosus （SLE）. Methods The clinic symptoms, laboratory tests. Doppler tests of patients who were diagnosed with PAH and SLE during last five years were analyze retrospectively. Results Anti-RNP antibody＇s prevalence rate was high. The presence of pulmonary arterial perssure （PAP） was not related to SLE disease active index （SLEDAI）. Those who had PAP higher than 45 mm Hg were prone to have Raynaud＇s phenomenon PAH had no association to auto-antibodies and other systemic lesions. There were no differences in clinic features, auto-antibodies and other examinations between those with kidney injure and without kidney injure. Conclusion PAH may develop insidiously in SLE, so early diagnosis and prompt treatment of PAH can improve the prognosis.