102例系统性红斑狼疮患者心脏损害分析

Cardiac Involvement in Systemic Lupus Erythematosus in 102 Cases

目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)心脏受累表现,并分析年龄、性别、病程及实验室指标与SLE心脏损害的相关性。方法回顾性总结分析2003年5月至2010年3月宁夏医科大学总医院初诊SLE的住院病人102例,其中合并心脏损害59例,无心脏损害43例。结果 SLE患者并心脏损害患者中心电图(ECG)ST-T异常23例(39.0%),窦性心动过速13例(22.0%),超声心动图(UCG)检查心包积液21例(35.6%),瓣膜病变20例(33.9%),肺动脉高压13例(22.0%)。心脏损害组与无心脏损害组之间年龄、性别差异无统计学意义(P>0.05),两组之间病程、血沉、C反应蛋白、抗ds-DNA结合率、补体C3、ANA负对数差异有统计学意义(P<0.05),经Logistic回归分析SLE心脏损害与血沉及抗ds-DNA结合率存在相关性(r=1.026和1.037)。结论 SLE可累及心脏各个部分,对于血沉、抗ds-DNA结合率明显异常的SLE患者,需及时行心电图、超声心动图检查,以提高其心脏损害的检出率,改善患者预后。

Objective To investigate cardiac manifestations in systemic lupus erythematosus （SLE） and to analyze the relationship between the cardiac abnormalities and the clinical characteristics of patients including sex, age, course of disease and laboratory index. Methods The clinical data in 102 cases with SLE admitted to the Affiliated Hospital of Ningxia Med. Univ. from May, 2003 to March, 2010 were reviewed. All the cases were divided into two groups：the cardiac involvement - group （59 cases）and the non cardiac involvement -group（43 cases）. Results There were 59 cases with cardiac involvement in 102 patients, including ST segment and/or T wave （ST- T） ischemic changes of electrocardiography （ECG） in 23 cases （39.0%）, sinus tachycardia in 13 cases （22.0%） ,pericardial effusion in 21 cases （35.6%） ,valve diseases in 20 cases （33.9%） ,pulmonary hypertension in 13 cases （22.0%）. The patients with cardiac involvement had no sig- nificant differences in gender and age （P 〉 0.05 ）. Significant difference between the two groups in course of disease,ESR,CRP,anti -dsDNA,C3 and ANA negative log were found（P 〈0.05）. The cardiac involvement had correlation with ESR and anti - dsDNA. Conclusion All components of the heart could be involved in SLE. In SLE cases with abnormal ESR and anti- dsDNA, assistant examination such as electrocardiogram, echocardiography should be given for imoroving the orognosis.