系统性红斑狼疮合并冠状动脉粥样硬化性心脏病的临床特点分析  

Clinical manifestation of patients with systemic lupus erythematosus and coronary artery disease

作　　者：林巧芬[1] 李海苗[1] 吴朝晖[1] 韩志远[1] 谢振宏[1] 

机构地区：[1]武警广东省总队医院心血管内科,广州510507

出　　处：《岭南心血管病杂志》2015年第4期455-458,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的分析系统性红斑狼疮(systemic lupus erythematosus,SLE)患者并发冠状动脉粥样硬化性心脏病(冠心病)的临床特点。方法将28例SLE合并冠心病患者作为观察组,选择同时期30例单纯冠心病患者作为对照组,比较两组患者的一般资料、超声检查结果、血清指标和5年生存率。结果观察组女性患者、发病年龄、体质量指数、吸烟史比例、糖尿病史比例、冠心病危险因素个数、高脂血症史比例均低于对照组,差异有统计学意义(P<0.05)。观察组患者丙氨酸氨基转氨酶、天冬氨酸氨基转氨酶、C-反应蛋白、肿瘤坏死因子-α浓度均高于对照组,三支病变发生率低于对照组,差异均有统计学意义(P<0.05)。合并急性冠脉综合征患者的24 h尿蛋白、糖皮质激素累计使用时间均高于无合并急性冠脉综合征患者,差异有统计学意义(P<0.05)。观察组5年累积生存率低于对照组,差异有统计学意义(HR=3.994,P<0.05)。结论 SLE合并冠心病患者以急性冠脉综合征为首发症状,传统危险因素个数较少,糖皮质激素使用时间较长。Objectives To analyze the clinical manifestation of patients with systemic lupus erythematosus（SLE） and coronary artery disease. Methods Totally 28 patients with SLE and coronary artery disease were selected as observation group, at the same period, 30 patients with coronary heart disease were selected as control group. General information, ultrasound results, serum indexes and 5-year survival rates were compared between the two groups.Results Percentage of female patients, age, body mass index, risk factors of coronary heart disease and percentage of smoking history, diabetes history, hyperlipidemia history in observation group were significantly lower than those in control group（P〈0.05）; Concentrations of alanine aminotransferase, aspartate aminotransferase, C-reactive protein,tumor necrosis factor-alpha were significantly higher in observation group than in control group（P〈0.05）, and rate of tri-vessel lesions was obvisouly lower in observation group than in control group（P〈0.05）. Accumulated usage duration of glucocorticoid and 24 h urine protein in patients with acute coronary syndromes（ACS） were higher than those in patients without ACS, the difference was statistically significant（P〈0.05）. Five-year accumulative survival rate in observation group was lower than that in control group, the difference was statistically significant（HR=3.994,P〈0.05）.Conclusions SLE patients with coronary heart disease take ACS as the initial symptom. Their traditional risk factors are fewer with a longer accumulated usage duration of glucocorticoid.

关 键 词：冠状动脉疾病 系统性红斑狼疮 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]