系统性红斑狼疮合并冠状动脉疾病的临床特征:一项匹配研究

Y. Guo, Y. Li, Y. Jia
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引用次数: 4

摘要

目的:分析系统性红斑狼疮(SLE)合并冠心病(CAD)患者的临床特点。方法:本研究使用阜外医院电子病历系统的数据。受试者包括合并CAD的SLE患者和无自身免疫性结缔组织疾病的性别和年龄匹配的CAD患者,比例为1:4。所有CAD患者均行冠状动脉造影(CAG)确诊。从所有受试者中提取心血管疾病(CVD)危险因素、实验室检查结果、超声心动图和CAG数据。结果:SLE合并CAD患者(n=22)的老年性心肌梗死(OMI) (p=0.000)、心肌梗死(MI) (p=0.001)、早发性CAD家族史(p=0.023)、高胆固醇血症(p=0.005)、绝经期(p=0.015)、肾脏疾病表现(p=0.000)、高CRP (p=0.000)比例显著高于CAD患者(n=88)。CAG显示SLE合并CAD患者多血管病变(p=0.015)和血管闭塞病变(p=0.006)较多。SLE合并CAD患者总胆固醇(TC)、血清肌酐、尿蛋白、b型利钠肽前体(前bnp)显著增高(p=0.000)。SLE合并CAD患者的死亡率高于CAD患者(p=0.029)。结论:这些结果表明SLE合并CAD患者比匹配的患者有更多的肾功能不全、高胆固醇血症和早发CAD家族史。此外,SLE合并CAD患者冠状动脉病变更广泛、更严重,易合并心功能障碍。
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Clinical Characteristics of Systemic Lupus Erythematosus Patients with Coronary Artery Disease: A Matched Study
Purpose: The aim of this study was to analyze the clinical characteristics of Systemic Lupus Erythematosus (SLE) patients with Coronary Artery Disease (CAD). Methods: This study used data from electronic medical records system from Fuwai Hospital. Subjects included SLE patients with CAD and gender-and, age-matched CAD patients without autoimmune connective tissue diseases in a ratio of 1:4. All CAD patients were confirmed by Coronary Angiography (CAG). Data from all subjects was abstracted for Cardiovascular Disease (CVD) risk factors, laboratory test results, echocardiography and CAG. Results: The proportion of old myocardial infarction (OMI) (p=0.000), myocardial infarction (MI) (p=0.001), family history of premature CAD (p=0.023), hypercholesterolemia (p=0.005), menopause (p=0.015), renal disease manifestation (p=0.000), and higher CRP (p=0.000) in SLE patients with CAD (n=22) were significantly higher than in CAD patients (n=88). CAG showed more multi-vessel lesions (p=0.015) and vascular occlusion lesions (p=0.006) in SLE patients with CAD. Total cholesterol (TC), serum creatinine, urine protein and B-type natriuretic peptide precursor (pro-BNP) were significantly higher in SLE patients with CAD (p=0.000). SLE patients with CAD had higher mortality than CAD patients (p=0.029). Conclusions: These results indicate that SLE patients with CAD have more renal insufficiency, hypercholesterolemia, and family history of premature CAD than matched patients. In addition, SLE patients with CAD have more extensive and severe coronary artery lesions, and are easily combined with cardiac dysfunction.
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