摘要
目的探讨无心脏临床症状的系统性红斑狼疮(SLE)患者早期左心室舒张功能减退的危险因素。方法纳入广东省梅州市人民医院风湿科无心脏临床症状的60例SLE患者及我院体检中心60例健康体检者为对照组,两组在年龄、性别、BMI、血压、心率方面相匹配。应用常规超声心动图及组织多普勒成像(TDI)对两组患者心脏进行检查,采用t检验、χ2检验分析比较两组心脏的各项参数的差异,通过多因素Logistic回归分析SLE患者早期左心室舒张功能减退的危险因素。结果与健康对照组相比,SLE患者左心室Em[(11.3±2.2)cm/s vs.(12.1±1.2)cm/s,P=0.041]更低,E/Em更高[(8.5±2.5)cm/s vs.(7.2±2.4)cm/s,P<0.001],差异有统计学意义。Em<10.0 cm/s的SLE患者的病程较长、SLEDAI评分及SLICC/ACR损伤指数较高、接受免疫抑制剂治疗的患者比例高。多因素Logistic回归分析显示病程长[OR=4.98,95%CI(1.06,12.37),P=0.042]、SLICC/ACR损伤指数≥1[OR=3.68,95%CI(1.43,9.49),P=0.007]和接受免疫抑制剂治疗[OR=5.35,95%CI(2.30,12.46),P<0.001]是SLE患者早期左心室舒张功能减退的危险因素。结论早期积极治疗SLE,使病情维持缓解,可降低患者心脏损害的发生率。
Objective To investigate the risks factors of early left ventricular diastolic dysfunction in patients with systemic lupus erythematosus （SLE）. Methods Sixty SLE patients without symptoms of heart involvement from Department of Rheumatology, Meizhou People’s Hospital and 60 healthy controls were involved in this study. t test and χ2 test were used for statistical analysis of the examination results of traditional echocardiography and TDI between patients and health subjects. Multivariate Logistic regression analysis was applied to investigate the risk factors for early left ventricular diastolic dysfunction. Results Compared with healthy subjects, Em was significantly lower[（11.3±2.2）cm/s vs. （12.1±1.2）cm/s, P=0.041] and E/Em was significantly higher[（8.5±2.5）cm/s vs. （7.2±2.4）cm/s, P＆lt;0.001] in SLE group. Patients with lower Em had longer disease duration, higher SLEDAI and SLICC/ACR damage index, and higher proportion of immunosuppressant therapy. The multi-factor Logistic regression analysis showed that disease duration [OR=4.98, 95% CI （1.06, 12.37）, P=0.042], SLICC/ACR damage index≥1 [OR=3.68, 95% CI （1.43, 9.49）, P=0.007] and immunosuppressant therapy [OR=5.35, 95% CI （2.30, 12.46）, P〈0.001] were risk factors for early left ventricular diastolic dysfunction. Conclusion Early aggressive treatment and maintain remission may reduce the incidence rate of heart damage in SLE patients.
出处
《中华临床医师杂志（电子版）》
CAS
2014年第18期58-61,共4页
Chinese Journal of Clinicians(Electronic Edition)
基金
广东省梅州市医药卫生科研立项(2013-B-24)
关键词
红斑狼疮
系统性
危险因素
组织多普勒成像
左心室舒张功能
Lupus erythematosus, systemic
Risk factors
Tissue Doppler imaging
Leftventricular diastolic function
