系统性红斑狼疮的心脏损害

目的：探讨系统性红斑狼疮（SLE）的心脏受累表现，并分析年龄、性别，病程及抗心磷脂抗体（ACL）与SLE心脏损害的相关性。方法：回顾性总结分析1998年9月至2000年8月我院诊断SLE的入院病人272例，结果：272例SLE病人中145例（53．3％）具有心脏损害，10例病人具有心脏病相关症状（6．7％），心脏损害包括心电图（ECG）ST－T异常61例（42．1％），心包积液60例（41．4％），肺动脉高压23例（15．9％），心肌损害22例（15．2％），心律失常20例（13．8％），瓣膜病19例（13．1％），左心耳血栓1例（0．6％）。心脏损害组与无心脏损害组之间年龄，性别差异无差异性（P＞0．05，病程差异有显著性（P＜0．01），ACL阳性组与阴性组瓣膜损害发生率差异有显著性（P＜0．01），结论：SLE可以累及心脏各个部分，其中以ECC ST－T缺血性改变和心包受累最为常见。SLE累及心脏时多属无症状型，SLE心脏损害与病程有关，抗心磷脂抗休与心脏瓣膜损害关系密切。

Cardiac involvement in systemic lupus erythematosus:a retrospective analysis of 272 systemic lupus erythematosus patients

Objective To investigate cardiac manifestations in systemic lupus erythematosus (SLE) and analyze the relationship between the cardiac abnormalities and the clinical characteristics of patients including sex,age,course of disease and anticardiolipin antibody (ACL).Method The clinical data in 272 cases of SLE admitted to Peking Union Medical College Hospital from Sept,1998 to Aug,2000 were reviewed.Results There were 145 cases with cardiac involvement in 272 patients and only 10 of them had cardiac symptoms (6 7%).The manifestations were numerous,including ST segment and/or T wave (ST T) ischemic changes of electrocardiography (ECG) in 61 cases (42 1%),pericardial effusion in 60 cases (41 4%),pulmonary hypertension in 23 cases (15 9%),myocardium lesions in 22 cases (15 2%),arrhythmia in 20 cases (13 8%),valve diseases in 19 cases (13 1%) and thrombus in left auricle of heart in 1 case (0 6%).The patients with cardiac involvement had no significant differences in sex and age comparing to those without ( P >0 05),but they had significantly longer course of disease ( P <0 01).Significant differences were found in valve abnormalities between the group with positive ACL and that with negative outcome ( P <0 01).Conclusion All components of the heart could be involved.ST T ischemic changes in ECG and pericardial effusion were most frequent among the cardiac manifestations.Most patients with cardiac leisions were asymptomatic.Cardiac involvement in SLE was related to the course of disease and there was close relationship between ACL and valve diseases.