抗Ro52抗体阳性的系统性红斑狼疮患者心血管损害的临床特点  

Clinical features of cardiovascular disease in systemic lupus erythematosus patients with positive anti-Ro52 antibody

作　　者：邓思梅 张桦[2] DENG Simei;ZHANG Hua(Clinical Nutrition Department,the Fourth Affiliated Hospital of Guangzhou Medical University,Guangzhou Medical University Guangzhou 511300,Guangdong,China;Rheumatology and Immunology Department,the Fifth Affiliated Hospital of Sun Yatsen University,Zhuhai 519000,Guangdong,China)

机构地区：[1]广州医科大学附属第四医院临床营养科,广东广州511300 [2]中山大学附属第五医院风湿免疫科,广东珠海519000

出　　处：《中国现代医生》2024年第17期51-53,58,共4页China Modern Doctor

摘　　要：目的分析抗Ro52抗体阳性的系统性红斑狼疮(systemic lupus erythematosus,SLE)患者心血管损害的特点,旨在探讨抗Ro52抗体对SLE心血管系统的影响作用。方法收集2015年1月至2020年10月于中山大学附属第五医院住院的SLE患者共517例患者的临床资料,根据抗Ro52抗体阳性与否,分为抗Ro52抗体阳性组和抗Ro52抗体阴性组,回顾比较两组出现各种类型心血管损害的特点及超声心动图参数。结果纳入517例SLE患者,361例患者合并心血管疾病(cardiovascular disease,CVD),占69.8%。抗Ro52抗体阳性组的SLE患者出现心血管系统受累的患病率较阴性组稍高(74.1%vs,68.6%),但差异无统计学意义(P>0.05)。两组均以瓣膜损害最为常见,心肌疾病次之,其余表现为心包积液、QTc间期延长、ST-T改变、心律失常、肺动脉高压、冠心病、急性心力衰竭等。抗Ro52抗体阳性的SLE患者左心房内径、左心室内径、左心室质量小于抗Ro52抗体阴性组,阳性组更容易出现严重的心血管系统损害(均P<0.05)。结论心血管系统是SLE最常累及的系统之一,主要表现为瓣膜损害、心肌病变、心包积液,严重者可出现急性心肌梗死、急性脑梗死、中重度肺动脉高压等心血管疾病。抗Ro52抗体可能对SLE心血管系统损害有一定的影响作用。Objective To retrospectively analyze the clinical characteristics of cardiovascular system involvement in systemic lupus erythematosus(SLE)patients with positive anti-Ro52 antibody and explore the role of anti-Ro52 antibody on the process of cardiovascular damage in SLE.Methods A total of 517 SLE patients admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from January 2015 to October 2020 were retrospectively analyzed.According to the result of anti-Ro52 antibody,the patients were divided into two groups,including the anti Ro52 antibody positive group and the anti Ro52 antibody negative group.The related clinical manifestations and echocardiographic parameters were collected and then analyzed by SPSS23.0.Results Among 517 SLE patients,361 patients(69.8%)suffered from cardiovascular disease.The incidence of cardiovascular system involvement in SLE patients with anti-Ro52 antibody positive group was similar to that of negative group(74.1%vs 68.6%,P>0.05).Cardiac valves disorders were the most common,followed by myocardial disease in both groups.Other manifestations were pericardial effusion,QTc interval prolongation,ST-T change,arrhythmia,pulmonary hypertension,coronary heart disease,acute heart failure,etc.(P>0.05).The parameters of echocardiography like the left atrial diameter,left ventricular diameter and left ventricular mass of SLE with anti-Ro52 antibody positive were smaller than those in the negative group,and the positive group was more likely to have serious cardiovascular system damage(P<0.05).Conclusion The cardiovascular system is one of the most frequently involved systems in SLE,mainly manifested as valve damage,myocardial lesions,and pericardial effusion.Some patients may even developed acute myocardial infarction,acute cerebral infarction,moderate to severe pulmonary hypertension and other fatal cardiovascular diseases.Anti-Ro52 antibody may have a certain effect on SLE with cardiovascular damage.

关 键 词：系统性红斑狼疮 心血管疾病 抗Ro52抗体 免疫 

分 类 号：R593[医药卫生—内科学]