系统性红斑狼疮的心脏瓣膜病变

目的　探讨心脏瓣膜病变与系统性红斑狼疮 (SLE)病人的其他临床特征和某些并发症之间的联系。方法　 10 4例SLE病人行超声心动图 (UCG)检查和有关狼疮的临床和实验室评价 ,UCG检查结果与 80名健康体检人员UCG检查结果进行对比。SLE病人和健康体检者随访约 4年。结果　SLE病人在初次和随访UCG中 ,瓣膜病变常见 ,发生率分别为 38%和 36 %。其中瓣膜增厚发生率最高 ,其次为瓣膜反流和赘生物。随访中瓣膜病变经常发生变化。瓣膜病变的存在与否与SLE病人的病程、狼疮活动、病情严重程度以及治疗方案无关。随访中有瓣膜病变的SLE病人的并发症(包括中风、外周栓塞、充血性心力衰竭、感染性心内膜炎和死亡 )发生率为 2 8% ,而无瓣膜病变者仅为 11%。结论　SLE病人瓣膜病变多见、易变 ,瓣膜病变的发生与病人的并发症发生率有关 ,而与病人的上述临床特征无关

Heart valvular disease of systemic lupus erythematosus

Objective To determine the relation of heart valvular disease to other clinical features and the complications in systemic lupus erythematosus (SLE).Methods Echocardiography (UCG) and clinical characteristic evaluation were performed in 104 patients with SLE.The UCG findings were compared with those in 80 healthy volunteers (controls).The patients and controls were followed up about 4 years.Results Valvular abnormalities were common on the initial and follow up UCG (in 38% and 36%of patients,respectively).Valvular thickening was predominant,followed by valvular regurgitation and vegetations.Valvular abnormalities freguently changed follow up.Valvular disease was not related to the duration,activity,or severity of lupus or to its treatment.The combined incidence of stroke,peripheral embolism,congestive heart failure,infective endocarditis and death was 28% in patients with valvular disease,but only 11% in those without valvular disease.Conclusion Valvular heart disease is common in patients with SLE,frequently changes on follow up,appears to be unrelated to above clinical characteristics of SLE,and is associated with the complications of SLE.