Kiss Emese, Soltesz Pal, Der Henrietta, Kocsis Zsolt, Tarr Tunde, Bhattoa Harjit, Shoenfeld Yehuda, Szegedi Gyula
Third Department of Internal Medicine, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary.
J Autoimmun. 2006 Dec;27(4):211-7. doi: 10.1016/j.jaut.2006.09.008. Epub 2006 Nov 7.
Systemic lupus erythematosus is associated with accelerated atherosclerosis and increased cardiovascular morbidity and mortality. Objectives were to determine endothelial dysfunction with a non-invasive method in lupus patients and to analyse correlation with risk factors and atherosclerotic complications. Sixty-one SLE patients and 26 healthy age- and sex-matched control subjects were entered into the study. The diameters of brachial artery at rest, during reactive hyperaemia, and after glyceril trinitrate administration, as well as the intima-media thickness of the common carotid artery were measured using high-resolution B-mode ultrasonography. Demographic characteristics, lipid profile, paraoxonase activity, concentration of anti-phospholipid antibodies and anti-oxLDL were assessed together with atherosclerotic complications. The endothelium dependent vasodilation (FMD) was significantly impaired in SLE patients as compared to controls. The absolute difference of vessel diameter (Deltad) was 0.25+/-0.15 mm vs. 0.38+/-0.16 mm (p=0.001), and Deltad as in percent of the rest diameter was 7.31+/-5.2% vs. 9.86+/-3.87% (p=0.013) in lupus patients and controls, respectively. Nitrate mediated dilation (NMD) did not differ. FMD negatively correlated with age, systolic and diastolic blood pressure in SLE, but did not show significant correlation with the other examined parameters. However, FMD significantly differed between SLE patients with (5.54+/-4.36%) and without (8.81+/-5.28%) cardiovascular complications (p=0.01). The determination of flow-mediated vasodilation is a useful method to detect endothelial dysfunction in lupus patients, as reduced capacity of brachial artery may distinguish between SLE patients and healthy subjects, as well as lupus patients with and without atherosclerotic vascular complications.
系统性红斑狼疮与动脉粥样硬化加速以及心血管发病率和死亡率增加相关。目的是用一种非侵入性方法确定狼疮患者的内皮功能障碍，并分析其与危险因素和动脉粥样硬化并发症的相关性。61例系统性红斑狼疮患者和26例年龄及性别匹配的健康对照者纳入本研究。使用高分辨率B型超声测量静息时、反应性充血时以及硝酸甘油给药后的肱动脉直径，以及颈总动脉的内膜中层厚度。评估人口统计学特征、血脂谱、对氧磷酶活性、抗磷脂抗体和抗氧化型低密度脂蛋白浓度以及动脉粥样硬化并发症。与对照组相比，系统性红斑狼疮患者的内皮依赖性血管舒张功能（FMD）显著受损。狼疮患者和对照组的血管直径绝对差值（Δd）分别为0.25±0.15mm和0.38±0.16mm（p=0.001），以静息直径百分比表示的Δd分别为7.31±5.2%和9.86±3.87%（p=0.013）。硝酸酯介导的舒张功能（NMD）无差异。在系统性红斑狼疮患者中，FMD与年龄、收缩压和舒张压呈负相关，但与其他检测参数无显著相关性。然而，有心血管并发症（5.54±4.36%）和无心血管并发症（8.81±5.28%）的系统性红斑狼疮患者之间FMD有显著差异（p=0.01）。血流介导的血管舒张功能测定是检测狼疮患者内皮功能障碍的一种有用方法，因为肱动脉功能降低可区分系统性红斑狼疮患者与健康受试者，以及有和无动脉粥样硬化血管并发症的狼疮患者。
