系统性红斑狼疮合并心肌受累病例分析

目的 通过对系统性红斑狼疮(SLE)心肌受累病例的分析,提高对本病的认识.方法 总结分析北京协和医院近10年共13例SLE心肌受累病例临床资料及预后.结果 SLE心肌受累发生率0.52%,糖皮质激素治疗前后左心室射血分数分别为(37.7±5.8)%和(40.9 ±7.1)%(P=0.002),抗rRNP抗体与治疗后左心室射血分数改善显著相关(r=0.843,P=0.001).cTnI与左心室舒张末期内径改善相关(r=0.656,P=0.036).结论 SLE心肌受累仍属罕见病,预后较差,心脏超声可早期诊断并监测病情,激素治疗可以改善症状,一些血清学指标与病情相关.

Myocardial involvement in 2494 patients with systemic lupus erythematosus

Objective To investigate the clinical characteristics and related pathogenetic factors in systemic lupus erythematosus(SLE)patients with myocardial involvement.Methods Clinic data and myocardial involvements were analyzed in 2494 SLE patients who admitted to our hospital from 1997 to 2007.Results Myocardial involvements were seen in 13 out of 2494 SLE patients(0.52%).Dyspnea of various degrees and left ventrieular systolic dysfunction are frequently found in these patients with myocardial involvements.Glucocorticoid therapy significantly increased left ventricular ejection fraction(LVEF,37.7%±5.8%vs.40.9%±7.1%, P=0.002).Significant associations were found between anti-rRNP antibody and LVEF(r=0.843, P=0.001)as well as between cardiac troponin Ⅰ(cTnI)and left ventricular end diastolic diameter(LVEDD)(r=0.656,P=0.036).Conclusions Myocardium is rarely affected in patients with SLE in this cohort.Echocardiography is a valuable method for detecting cardiac abnormalities in patients with SLE.Glucocorticoid therapy could improve cardiac function in SLE patients with cardiac involvement and serological factors are related to cardiac functions.