Hogarth M B, Judd L, Mathias C J, Ritchie J, Stephens D, Rees R G
Rheumatology Unit, Imperial College School of Medicine, St Mary's Hospital, London, UK.
Lupus. 2002;11(5):308-12. doi: 10.1191/0961203302lu194oa.
To determine whether cardiovascular autonomic function is impaired in systemic lupus erythematosus (SLE).
A case-control study of 23 patients with SLE was performed. Autonomic symptoms were assessed using a standard questionnaire. Cardiovascular autonomic function was measured using 10 non-invasive investigations. There were significant differences between patients and controls in three out of 24 parameters measured during the different tests (P < 0.002). These were reduction in systolic blood pressure at 5 min on head-up tilt, and heart rate responses to isometric exercise and cutaneous cold. Eleven out of 23 patients had an abnormal heart rate, blood pressure or Valsalva response (value below the age corrected 5th centile) while testing compared with six of the controls. Plasma adrenaline and noradrenaline levels were significantly lower in patients vs controls in both the supine (P < 0.05) and tilt position (P < 0.01). Twenty-one of the 23 patients had one or more symptoms that may be attributable to abnormalities in autonomic function. There was no significant association between the number of symptoms and presence of autonomic dysfunction. Cardiovascular autonomic impairment may be demonstrated in some patients with SLE. Symptoms attributable to autonomic dysfunction are common in SLE and autonomic assessment may be required.
确定系统性红斑狼疮（SLE）患者的心血管自主神经功能是否受损。
对23例SLE患者进行病例对照研究。使用标准问卷评估自主神经症状。采用10项非侵入性检查测量心血管自主神经功能。在不同测试中测量的24项参数中有3项在患者和对照组之间存在显著差异（P < 0.002）。这些参数为头高位倾斜5分钟时收缩压降低，以及等长运动和皮肤冷刺激时的心率反应。与6名对照组相比，23例患者中有11例在测试时心率、血压或瓦尔萨尔瓦动作反应异常（数值低于年龄校正后的第5百分位数）。患者仰卧位（P < 0.05）和倾斜位（P < 0.01）时血浆肾上腺素和去甲肾上腺素水平均显著低于对照组。23例患者中有21例有一项或多项可能归因于自主神经功能异常的症状。症状数量与自主神经功能障碍的存在之间无显著关联。部分SLE患者可能存在心血管自主神经功能损害。SLE患者中归因于自主神经功能障碍的症状很常见，可能需要进行自主神经评估。
