系统性红斑狼疮相关肺动脉高压26例临床分析  

Clinical analysis of 26 cases of pulmonary arterial hypertension in patients with systemic lupus erythematosus

作　　者：王丽伟 胡大伟[2] 

机构地区：[1]安徽省合肥市第一人民医院风湿科,安徽合肥230061 [2]上海交通大学医学院附属仁济医院风湿科,上海200001

出　　处：《中日友好医院学报》2012年第2期83-85,共3页Journal of China-Japan Friendship Hospital

摘　　要：目的:探讨系统性红斑狼疮(SLE)相关肺动脉高压(PAH)的临床表现、诊治和预后。方法:回顾性分析26例SLE合并PAH住院患者的临床和随访资料。按PAH数据,将其分为轻中度组(40～60mmHg)和重度组(≥61mmHg)结果:患者主要临床表现是呼吸困难(88.5%)、雷诺现象(57.7%),心功能分级Ⅰ、Ⅱ、Ⅲ、Ⅳ级分别占10.8%、37.8%、27%、24.3%。治疗后肺动脉收缩压(PASP)由(67.0±25.9)mmHg降至(52.6±20.0)mmHg(P<0.05)。平均随访6.7±5.4个月,死亡率15.4%。重度组雷诺现象、SLE疾病活动指数(SLEDAI)评分及肺间质病变发生率均显著高于轻中度组(均P<0.05)。结论:SLE相关PAH的主要表现是呼吸困难、雷诺现象。重度PAH患者死亡率高,定期对SLE患者进行超声心动图检查对筛查PAH非常必要。Objective：To investigate the clinical features and prognosis of pulmonary arterial hypertension（PAH）secondary to systemic lupus erythematosus（SLE）.Methods：Twenty-six patients diagnosed as having SLE associated PAH were retrospectively analyzed.The patients were grouped to severe PAH group（≥61mmHg）and mild and moderate group（40~60mmHg）,respectively.Results：The most common clinical manifestations of SLE associated PAH were dyspnea on exertion（88.5%）and Raynaud′s phenomenon（57.7%）.The mean pulmonary artery systolic pressure（PASP）in SLE patients received treatment for arterial pulmonary vasodilators and immunosuppressive agents,the condition of elevated PASP had decrease from（67.0±25.9）mmHg to（52.6±20.0）mmHg.Among them,15.4% patients died during an average of 6.7±5.4 months follow-up.More Raynaud′s phenomenon,higher SLEDAI and rates of interstitial lung disease were observed in severe PAH group compared to mild and moderate group（all P0.05）.Conclusion：The most common manifestations of SLE associated PAH are dyspnea on exertion and Raynaud′s phenomenon.SLE associated PAH could be very severe,and therefore reduce the survival rates of the patients.Doppler echocardiography are necessary to detect PAH early.

关 键 词：肺动脉高压 红斑狼疮 系统性 超声心动描记术 

分 类 号：R593.241[医药卫生—内科学] R543.2[医药卫生—临床医学]