初发系统性红斑狼疮并发肺动脉高压患者的临床特点  

Clinical characteristics of newly-diagnosed systemic lupus erythematosus patients with pulmonary hypertension

作　　者：张冬梅 洪登校 宫牧雪 范晓云[1] 周瀛 叶明[1] 陈琳洁[1] 谢长好[1] ZHANG Dong-mei;HONG Deng-xiao;GONG Mu-xue;FAN Xiao-yun;ZHOU Ying;YE Ming;CHEN Lin-jie;XIE Chang-hao(Department of Rheumatology,The First Affliated Hospital of Bengbu Medical College,Bengbu 233004,Anhui,China)

机构地区：[1]蚌埠医学院第一附属医院风湿免疫科,安徽蚌埠233004

出　　处：《中华临床免疫和变态反应杂志》2022年第4期383-387,共5页Chinese Journal of Allergy & Clinical Immunology

基　　金：安徽省自然科学基金(2108085MH258)。

摘　　要：目的分析初发系统性红斑狼疮(systemic lupus erythematosus,SLE)并发肺动脉高压(pulmonary hypertension,PH)患者的临床和实验室特点及危险因素,分析治疗及治疗后疾病的转归。方法对2018年1月至2021年1月在蚌埠医学院第一附属医院风湿免疫科住院治疗的13例初发SLE-PH患者进行回顾性研究,同期住院的193例初发SLE-nonPH患者作为对照组,对两组的一般资料、临床表现、实验室检查、治疗及治疗转归进行比较分析。结果住院SLE患者的PH发生率为3.88%,初发SLE-PH发生率为1.29%。PH常见的临床表现有胸闷(69.2%)、气喘活动后气喘(61.5%)、乏力(61.5%)、胸痛(23.1%)、心悸(15.4%)、干咳(15.4%)。PH组胸闷、气喘活动后气喘、胸痛、心包炎、胸腔积液、ILD发生率,血浆D-二聚体、尿酸水平、SLEDAI评分高于non-PH组。结论SLE患者出现PH相关症状时,应行PH筛查,无相关症状的SLE患者在病情活动时特别是并发心包炎、胸腔积液时应警惕PH的发生,及早行PH筛查。Objective To analyze the clinical characteristics and risk factors of pulmonary hypertension(PH)in patients with systemic lupus erythematosus(SLE).Methods 13 newly-diagnosed SLE-PH patients were enrolled from the Department of Rheumatology,First Affiliated Hospital of Bengbu Medical College from January 2018 to January 2021.193 newly-diagnosed SLE-nonPH patients were taken as control group.Clinical manifestations,laboratory testing,treatment,and outcome between the two groups were retrospectively compared and analyzed.Results The incidence of PH in hospitalized SLE patients was about 3.88%,and the incidence of newly-diagnosed SLE-PH was 1.29%.The common clinical manifestations of PH were chest tightness(69.2%),short-of-breath after exercise(61.5%),fatigue(61.5%),chest pain(23.1%),palpitation(15.4%),and dry cough(15.4%).The incidence of chest tightness,short-of-breath after exercise,chest pain,pericarditis,pleural effusion,interstitial lung disease,the levels of D-dimer,uric acid,and SLEDAI scores in SLE-PH group were higher than those in SLE-nonPH group.Conclusion For SLE patients with pericarditis and pleural effusion,the occurrence of PH should be alerted and screening should be performed,even though they have no PH related symptoms.

关 键 词：系统性红斑狼疮 肺动脉高压 初发 

分 类 号：R593.241[医药卫生—内科学] R544.1[医药卫生—临床医学]