SLE患者心脏病变临床分析

A Clinical Analysis about the patients of Cardiac involvement in Systemic Lupus Erythematosus

目的:探讨系统性红斑狼疮患者心脏病变的发生情况、临床表现以及心电图等检查在心脏病变诊断中的意义。方法:回顾性分析深圳市光明新区公明人民医院自2005年1月至2009年1月诊治的109例SLE患者的临床资料,对患者的一般情况、心脏病变临床表现与体征,相关检查情况进行调查,统计相关数据,得出相应结论。结果:109例SLE有心脏病变的患者共62例,主要的临床表现有:心慌55例(50.46%),气急38例(34.86%),胸闷24例(22.02%),心前区不适19例(17.43%),心前区疼痛11例(10.09%),心衰2例(1.83%),心肌梗死1例(0.92%)。所有患者中有99例患者进行过心电图检查,其中有58例存在异常,占53.21%。其中T波改变47例(43.12%),窦性心动过速41例(37.61%)最为常见;109例病例中有75例进行过心脏超声和/或胸部X线检查,其中有29例显示异常,占26.61%,所提示的异常依次为:心包积液18例(16.51%),心包粘连5例(4.59%),心脏增大15例(13.76%),二尖瓣轻度脱垂2例(1.83%)、二尖瓣轻度返流1例(0.92%)。结论:SLE患者心脏病变较常见,心脏超声/胸片可发现部分心脏异常,虽然这些常规检查特异性有限,但可作为无创伤性检查反复进行,以尽早发现可能的心脏病变。

Objective：To investigate the morbidity and clinic features of cardiac manifestations in patients with systemic lupus erythematosus（SLE）,and to investigate the significance of the cardiac routine examinations.Methods：109 patients with SLE were admitted into Shenzhen Gongming people＇s Hospital between Jan 2005 to Jan 2009.The items,which include the general data of the patients, course of disease, the related symptom and sign,the laboratory examination,the special examination. Then analysis the data by statistical methods to get the results.Results：In these patients 62patients（56.88%） had related symptoms：palpitation（55,50.46%）,breath lessness（38,34.86%）,chest distress（24,22.02%）,precordium faintness（19,17.43%）,precordiumpain（11,10.09%）,heart failure （2,1.83%）,myocardial infarction（l,0.92%）.99 patients had the examination of ECG,and 58 patients had abnormal results：T wave changes（47,43.12%）,sinus tachycardia（41,37.61%） were common,Among the 109 patients, there were 75 patients had the examination of ultrasound and/or X-ray.29 patients（26.61%） had abnormal results：pericardial effusion（l 8,16.51%）,cardiac enlargement （15,13.76%）,pericardiosymphysis（5,4.59%）,valvular mitralis slight prolapse （2,1.83%）,valvular mitralis sligh backstreaming（l,0.92%）.Conclusion：Cardiac involvement is common in SLE,According to the examination of ultrosound and X-ray, some cardiac abnormality can be found.Although those examinations were not specific,they can be used to find the cardiac lesion earlier. At the same time,they can be done repeatedly because they are noninvasive.The further research is needed to discuss the relationship between cardiac involvement and SLE.