系统性红斑狼疮并发心脏损害的临床分析

目的分析系统性红斑狼疮（SLE）并发心脏损害的临床特点，探讨SLE心脏受累的相关危险因素。方法采用心电图、超声心动图和血清学检查对239例SLE患者的心脏损害进行评估，并对有无并发心脏损害SLE患者的临床和实验室资料进行对比分析。结果239例SLE患者中有114例（47．7％）存在心脏损害，其中31例（27．2％）具有临床心脏病相关症状，心包积液44例（38．6％），心肌损害32例（28．1％），瓣膜病变14例（12．3％），心脏传导阻滞19例（16．7％），其他心脏损害13例（11．9％）。与从无心脏损害患者中随机选择的64例患者对照分析，并发心脏损害者在年龄、性别比、病程、SLE病情活动指数（SLEDAI）积分、自身抗体、补体水平等方面差异均无统计学意义；但存在心包炎和心肌损害者SLEDAI积分较对照组明显增高（P〈0．05）、补体C3水平则明显降低（P〈0．05），而并发瓣膜病变的患者病程较长。结论SLE并发心脏损害常见，活动性和病情较重患者易于并发心包炎和心肌损害，而病程较长则易发生瓣膜病变。

Analysis of cardiac involvement in patients with systemic lupus erythematoms

Objective To study clinical characteristics in patients of systemic lupus erythematosus (SLE)with cardiac involvement and to assess relevant risk factors contributed to it.Methods Totally,239 patients of SLE were evaluated by cardiogram,echocardiogram and serologic examinations,and those with cardiac involvement were compared to those without it by clinical and laboratory data.Results There were 114 of 239(47.7%)SEE patients with cardiac abnormalities,of whom only 31(27.2%)had cardiac symptoms,including 44 cases(38.6%)with hydropericardium,32(28.1%)with myocardial damage,14 (12.3%)with cardiac valvular lesions,19(16.7%)with cardiac block,and 13 with other cardiac damages.No significant difference in age,gender,course of disease,SLE activity index(SEEDAI)scores,serum levels of auto-antibodies and complement(C3),and so on,were found between 114 SLE patients with cardiac abnormalities and 64 without it,who were:randomly selected from 125 patients of SEE without cardiac damage.But,patients of SLE complicated with pericarditis or myocardial lesions had higher SLEDAI scores and lower serum level of C3 than those without cardiac lesions(both P＜0.05),and relatively longer course of disease was found in those with valvular heart disease.Conclusions Cardiac damage was common in patients with SLE,but most of whom were asymptomatic,and only those with severe and active illness tended to develop pericarditis and myocardial damage and those with longer course were liable to have valvular heart disease.