代谢综合征与狼疮性肾炎患者的颈动脉粥样硬化相关

Metabolic Syndrome is Correlated with Carotid Atherosclerosis in Patients with Lupus Nephritis

目的:探讨狼疮性肾炎(lupus nephritis,LN)患者代谢综合征(metabolic syndrome,MS)的发病情况及与颈动脉粥样硬化的相关性。方法:入选我院肾脏科LN患者共210例,计算MS的发生率,以颈动脉超声检测斑块和内膜中层厚度(IMT),分析MS与颈动脉粥样硬化的关系。结果:本组LN患者中MS的发生率为41.90%。存在MS的患者颈动脉斑块比例(28.41%vs 17.21%,P<0.05)和IMT值[(0.74±0.25)mm vs(0.64±0.18)mm,P<0.01]显著升高。随着MS组成病种数的增加,颈动脉IMT水平呈逐渐增高趋势(P<0.01)。逐步多元线性回归进一步证实年龄(β=0.026,P=0.033)、病程(β=0.057,P=0.025)和MS(β=0.074,P<0.001)是影响颈动脉IMT值的独立危险因素。结论:LN患者中MS的发生率较高,且与颈动脉粥样硬化显著相关,提示筛查MS对于LN患者动脉粥样硬化病变的防治可能具有重要的临床价值。

Objective： To investigate the prevalence of metabolic syndrome（ MS） in patients with lupus nephritis（ LN）,and its correlation with carotid atherosclerosis. Methods： 210 patients with LN were enrolled and the prevalence of MS was calculated.Carotid artery ultrasound was used to detect plaque and intima media thickness（ IMT）. The correlation between MS and carotid atherosclerosis was analyzed. Results： The prevalence of MS in this cohort was 41. 90%. Patients with MS showed a significantly increased carotid plaque ratio（ 28. 41% vs. 17. 21%,P〈0. 05） and IMT value [（ 0. 74 ± 0. 25） mm vs.（ 0. 64 ± 0. 18） mm,P〈0. 01）. As the number of MS components increased,the IMT value in LN patients showed a gradual upward trend（ P〈0. 01）. Stepwise multiple regression further confirmed that age（ β = 0. 026,P = 0. 033）,duration of disease（ β = 0. 057,P = 0. 025）,and MS（ β = 0. 074,P〈0. 001） were independent risk factors that affected the IMT value of the carotid artery. Conclusion： Our results showed that MS was significantly correlated with carotid plaque and IMT,indicating that MS screening might be of great clinical importance in the prevention and treatment of carotid atherosclerosis in patients with LN.