超声对系统性红斑狼疮患者肱动脉血管内皮功能的诊断

Ultrasonographic study of brachial artery endothelial function in patients with systemic lupus erythematosus

目的:超声检查观察系统性红斑狼疮(systemic lupus erythematosus,SLE)患者肱动脉血管内皮功能的变化,探讨超声评估SLE患者内皮功能的临床价值,为早期诊断提供依据。方法:选择确诊的SLE患者60例,并根据病程分为SLEⅠ组和SLEⅡ组各30例,另选同期进行健康体检者30例作为对照组,各组患者均进行肱动脉血管内皮功能超声检查,观察SLE患者肱动脉血管内皮功能的变化。结果:各组受检者的肱动脉基础内径(D0)对比差异无统计学意义(P>0.05);SLEⅠ组、SLEⅡ组受检者的反应性充血诱发的肱动脉内径变化率(foot-and-mouth disease,FMD)及舌下含服硝酸甘油再次诱发肱动脉的内径变化率(nonsense-mediated mRNA decay,NMD)都低于对照组受检者的肱动脉内径变化率(P<0.05),且SLEⅡ组差异更为明显。结论:通过观察SLE患者肱动脉血管内皮功能的变化,能够有效评价其血管内皮功能,对SLE患者亚临床动脉粥样硬化进行早期评估,指导临床早期干预,从而减少SLE患者心血管事件的发生,具有较好的临床应用价值。

Objective： To observe the changes of vascular endothelial function of brachial artery in patients with systemic lupus erythematosus （ SLE ） by ultra- sonography, and evaluate the clinical value of ultrasonography in assessing endothelial function in patients with SLE in order to provide evidence for early diagnosis. Methods： 60 cases of patients confirmed with SLE were divided into SLE ] group （30 cases） and SEE 11 group （30 cases） according to the course of disease. In ad- dition, 30 healthy subjects were selected as control group. The endothelial function of brachial artery in the three groups was examined by ultrasonography to obser,;e their changes. Results： The basic internal diameter of brachial artery （DO） in the three groups had no significant difference （ P 〉 0.05 ）. The reactive hyperemia - induced and sublingual nitroglycerin -induced changes of biachial artery diameter （FMD） in SLE I and SLE II group were significantly lower than those in control group （ P 〈 0.05 ）, and the difference in SLE 1] group was more significant. Conclusion： The changes of vascular endothelial function of brachial artery can effec- tively evaluate the endothelial function of SLE patients. The early assessment of subclinical atherosclerosis in SLE patients can guide early clinical intervention and re- duce the occurrence of cardiovascular events in SEE patients. It has good clinical value.