系统性红斑狼疮患者动脉粥样硬化危险因素分析

Risk factors of atherosclerosis in patients with systemic lupus erythematosus

系统性红斑狼疮（SLE）是以多器官损害症状为临床表现的慢性系统性自身免疫性疾病之一，其早期死亡的主要原因为疾病本身的活动和感染。随着SLE患者生存时间的延长，早发动脉粥样硬化（ath-erosclerosis，AS）的趋势日显突出。流行病学研究发现，SLE患者亚临床AS的发生率显著高于对照组。免疫抑制剂如环孢素等的使用对LDL及胆固醇有直接效应，并可能使动脉粥样病变加速[1]。传统危险因素如糖尿病、血脂异常及高血压等在SLE患者中更常见，但这些传统危险因素并不能完全解释SLE患者早发AS。越来越多的研究发现，自身抗体、系统性炎症反应、免疫复合物及内皮功能等是SLE患者早发AS的潜在危险因素。

The prevalence of atherosclerotic plaque on the neck in 60 premenopausal women with SLE and 40 healthy controls were examined by ultrasonography. All the participants hadn＇t history of cardiovascular disease. The relationship between cardiovascular risk factors, such as VEGF, TC, TG, LDL, HDL, Lp（a） and carotid plaque were studied. Carotid plaques were found in 13 SLE patients （21.6%）, while only one in the healthy control subjects （2.5%）. Compared with controls, SLE patients had significantly higher levels of VEGF, TC, TG, LDL and lower level of HDL （all P〈0.05）. SLE patients with carotid plaque had a longer course of disease, sig- nificantly higher level of VEGF, and lower level of HDL （all P〈0.05）.