系统性红斑狼疮合并心血管损害患者临床分析

    Clinical analysis of patients with systemic lupus erythematosus complicated with cardiovascular damage

      摘要
    • 摘要:
      目的 对合并心血管损害的系统性红斑狼疮（SLE）患者进行临床分析，预测其临床预后。
      方法 纳入2022年01月～2023年11月于空军军医大学唐都医院风湿免疫科住院的系统性红斑狼疮患者174例，根据是否合并心血管损害分为两组，其中合并心血管损害患者90例，未合并心血管损害患者84例，收集患者的临床资料进行统计分析。
      结果 与未合并心血管损害的SLE患者相比，合并心血管损害的SLE患者SLEDAI评分高（P<0.05），年龄大（P<0.01），抗ds-DNA抗体（P<0.01）及抗ds-DNA滴度>32发生率高（P<0.05），肾脏受累的发生率高（P<0.01）；BUN/Cr（P<0.01）、FAR（P<0.01）、CAR（P<0.05）、BAR（P<0.01）、BUN（P<0.01）、Cr（P<0.01）、CysC（P<0.01）、CRP（P<0.05）及ESR（P<0.01）水平升高，而PLT（P<0.05）、LYM（P<0.05）、RBC（P<0.01）、HGB（P<0.01）及ALB（P<0.01）则降低；采用Spearman进行相关分析，合并心血管损害的SLE患者年龄、FAR、CAR、CysC及ESR与CRP呈正相关（P<0.01），HGB（P<0.05）、ALB（P<0.01）及LCR（P<0.01）与CRP呈负相关，合并心血管损害的SLE患者FAR、CAR、CysC及CRP与ESR呈正相关（均P<0.01），RBC、HGB、ALB及LCR与ESR呈负相关（均P<0.01）；年龄（P<0.05）、PLT（P<0.05）、RBC（P<0.01）、HGB（P<0.01）及ALB（P<0.01）与SLEDAI呈负相关，BUN/Cr（P<0.05）、BAR（P<0.01）、BUN（P<0.01）、Cr（P<0.01）及Cys C（P<0.01）与SLEDAI呈正相关（P<0.05）。
      结论 合并心血管损害的系统性红斑狼疮患者年龄更高，抗ds-DNA抗体及抗心磷脂抗体阳性率高，易合并肾脏受累，全身炎症水平高，疾病活动度高，临床预后相对差。

       

      Abstract:
      AIM To analyze the clinical characteristics and prognosis of systemic lupus erythematosus (SLE) patients with cardiovascular involvement.
      METHODS A total of 174 SLE patients hospitalized in the Department of Rheumatology and Immunology of the Second Affiliated Hospital of Air Force Medical University from January 2022 to November 2023 were included in this study. According to whether they were complicated with cardiovascular damage, they were divided into two groups, including 90 patients with cardiovascular damage and 84 patients without cardiovascular damage. The clinical data of the patients were collected and analyzed.
      RESULTS Compared with SLE patients without cardiovascular damage, SLE patients with cardiovascular damage have higher SLEDAI scores (P<0.05), older age (P<0.01), higher incidence of anti ds DNA antibodies (P<0.01) and anti ds DNA titers>32 (P<0.05), and higher incidence of renal involvement (P<0.01); The levels of BUN/Cr (P<0.01), FAR (P<0.01), CAR (P<0.05), BAR (P<0.01), BUN (P<0.01), Cr (P<0.01), CysC (P<0.01), CRP (P<0.05), and ESR (P<0.01) increased, while PLT (P<0.05), LYM (P<0.05), RBC (P<0.01), HGB (P<0.01), and ALB (P<0.01) decreased; Spearman was used for correlation analysis, and age (P<0.01), FAR (P<0.01), CAR (P<0.01), CysC (P<0.01), and ESR (P<0.01) were positively correlated with CRP in SLE patients with cardiovascular damage. HGB (P<0.05), ALB (P<0.05), and LCR (P<0.01) were negatively correlated with CRP. FAR, CAR, CysC, and CRP were positively correlated with ESR in SLE patients with cardiovascular damage (all P<0.01), while RBC, HGB, ALB, and LCR were negatively correlated with ESR (all P<0.01); Age (P<0.05), PLT (P<0.05), RBC (P<0.01), HGB (P<0.01), and ALB (P<0.01) are negatively correlated with SLEDAI, while BUN/Cr (P<0.05), BAR (P<0.01), BUN (P<0.01), Cr (P<0.01), and Cys C (P<0.01) are positively correlated with SLEDAI (P<0.05).
      CONCLUSIONS SLE patients with cardiovascular involvement tend to be older in age and have higher positive rates of anti-ds-DNA antibody and anticardiolipin antibody. They are more likely to be associated with renal involvement and have higher levels of systemic inflammation, higher disease activity and poorer clinical prognosis.

       

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