系统性红斑狼疮心脏受累85例超声心动图的临床特征分析

Clinical cardiac imaging characteristics and influencing factors in 85 cases patients with systemic lupus erythematosus

目的探讨系统性红斑狼疮(SLE)心脏影像学的临床特征与影响因素,了解SLE患者心脏结构与功能的变化及其与病程、病情活动度的相关性。方法回顾性总结分析2008年1月至2009年7月我院诊断SLE的住院患者85例。结果①室间隔(IVST)、左心室后壁(LVPWT)、左心室等容舒张时间(IVRT)与病程关系密切(r=0.224、0.213、0.321,P<0.01或<0.05);②左心房前后径(LA)、LVPWT、每搏射血量(SV)与SLEDAI积分相关(r=0.323、0.217、0.222,P<0.01或<0.05);③病程5年以上组充盈早期速率/舒张晚期速率(E<A)比例明显大于病程5年以下组(P<0.05)。结论病程与SLE患者心脏损害有关,影响结构指标极为广泛,与左心室舒张功能关系密切,与收缩功能相关性不明显。而病情活动度影响心脏结构的范围较小,而与收缩功能有一定关系。SLE患者左心室舒张功能受损是慢性过程,收缩功能下降是病情活动的结果 ,如果这种下降是在舒张功能受损基础上,后果将极为严重。

Objective To investigate clinical cardiac imaging characteristics and influencing factors in systemic lupus erythematosus（SLE）.Methods 85 SLE cases hospitalizing during Jan.2008 to Jun.2009 were included in the study,and the relationship between the changes in structure and the function of the heart with the disease course and systemic lupus erythematosus disease activity index（SLEDAI） in SLE patients were analyzed.Results ①We found that interventricular septum（IVST）,left ventricular posterior wall（LVPWT） and isovolumetric relaxation time（IVRT） were positively correlated with the disease course（r=0.224,0.213,0.321,P〈0.01 or 0.05）.②There were positive correlation between left atrium（LA）（r=0.323,P〈0.01） and SLEDAI,LVPWT and SLEDAI（r=0.217,P〈0.05）,stroke volume（SV） and SLEDAI（r=0.222,P〈0.05）.③The percentage of EPFV and APFV（E〈A） in group with the duration of five years or longer was significantly larger than that with the shorter duration（P〈0.05）.Conclusion Disease course was related to cardiac damage in SLE patients,and has a certain relationship with the damage in diastolic function.The degree of disease activity has a certain relationship with left ventricular systolic function impaired in cardiac damage in SLE patients.