系统性红斑狼疮患者肱踝脉搏波传导速度及相关危险因素探讨

Brachial-ankle pulse wave velocity and associated risk factors in patients with systemic lupus erythematosus

目的探讨绝经期前系统性红斑狼疮(SLE)女性患者动脉血管僵硬度的情况及其与传统动脉硬化危险因素及疾病相关因素的关系。方法采用动脉硬化测定仪检测84例绝经期前SLE女性患者及68名健康女性肱踝脉搏波传导速度(baPWV)了解动脉血管僵硬度。分析两组患者血压、血脂、血糖、体重指数等传统心血管疾病危险因素的差异,并对SLE疾病相关因素与baPWV之间的关系进行研究。结果与健康对照组相比,SLE患者组中baPWV(1378.10±247.10cm/s)显著升高(P=0.000)。SLE患者中有38例(45.24%)baPWV>1400cm/s,健康对照组中仅4例(5.88%)baPWV>1400cm/s(P=0.0007)。baPWV与低密度脂蛋白、收缩压及舒张压成正相关(r=0.481,0.370,0.414,均P<0.05)。SLE患者中,相对于baPWV<1400cm/s者,baPWV>1400cm/s患者年龄更大、有更长的病程、SLEDAI、SLICC及hs-CRP均更高。但自身抗体及补体水平无差异。有肾损害的SLE患者,baPWV较无肾损害明显升高。结论在绝经期前SLE女性患者动脉血管僵硬度增高的发生率明显增高。除传统动脉硬化危险因素影响外,SLE疾病相关的一些因素也参与其中。

Objective To examine the brachial-ankle pulse wave velocity（baPWV）and associated risk factors in premenopausal women with systemic lupus erYthematosus（SLE）.Methods Atherosclerosis Tester was used to examine baPWV in 84 premenopausal female SLE patients and 68 healthy controls without clinical cardiovascular disease.We evaluated the association between traditional cardiovascular risk factors including hypertension,lipid profile,obesity,age and baPWV.The relationship between the patient＇s clinical characteristics and baPWV was examined.Results 38 of 84（45.24%） premenopausal female SLE patients had baPWV grater than 1400cm/s.However,baPWV grater than 1400cm/s was found in just 4 cases（5.88%） of 68 healthy control subjects（P=0.0007）.A positive correlation between baPWV and LDL-C,SBP and DBP was obserVed（r=0.481,0.370,0.414,P〈0.05）.Compared with SLE patients with baPWV lower than 1400cm/s,SLE patients with baPWV higher than 1400cm/s had Longer disease duration,higher level hs-CRP,higher SLEDAI score and SLICC score,but there was no difference in autoantibodies and complements.Higher baPWV was found in SLE patients with nephritis than patients without nephritis.Conclusion SLE patients present highr prevalence of increased vascular stiffness than healthy controls.In addition to traditional risk factors for cardiovascular disease,SLE itself and disease related factors play important roles in progress.