Colombo Barbara Maria, Murdaca Giuseppe, Caiti Matteo, Rodriguez Guido, Grassia Lidia, Rossi Edorado, Indiveri Francesco, Puppo Francesco
Department of Internal Medicine, University of Genova, Genova, Italy.
Ann N Y Acad Sci. 2007 Jun;1108:121-6. doi: 10.1196/annals.1422.014.
Accelerated atherosclerosis is an emerging problem in patients with systemic lupus erythematosus (SLE). We planned an observational study to determine whether in patients with SLE carotid intima-media thickness (IMT) represents an early sign of accelerated atherosclerosis and to confirm that SLE adds to the traditional cardiovascular Framingham risk factors. Thirty females with SLE (age 18-65 years) underwent anamnestic, clinical, and laboratory evaluation and B-mode ultrasonography of carotid arteries, which provides a direct and noninvasive assessment of subclinical atherosclerosis. IMT measurements were performed on the right and left common carotid arteries 1.0 cm proximal to the carotid bulb and the mean IMT value was calculated with a dedicated software. The Framingham Point Score was also calculated for each subject. SLE patients showed a mean IMT value of 0.73 +/- 0.12 (SD) mm. This value is significantly (P < 0.05) higher than that reported for an age-matched healthy female control population (0.66 +/- 0.11 SD mm). A preliminary evaluation of the Framingham Point Score, estimating the 10-year risk for women to develop cardiovascular events, indicated an increased risk of early cardiovascular events in SLE patients. In our study we have shown that patients with SLE have an increased mean IMT value compared with a healthy females control. Moreover, the evaluation of the Framingham Point Score suggests that SLE is an additional risk factor for cardiovascular disease.
加速性动脉粥样硬化是系统性红斑狼疮(SLE)患者中一个新出现的问题。我们计划开展一项观察性研究,以确定在SLE患者中颈动脉内膜中层厚度(IMT)是否代表加速性动脉粥样硬化的早期迹象,并证实SLE增加了传统的心血管疾病弗明汉姆风险因素。30名年龄在18至65岁之间的SLE女性患者接受了问诊、临床和实验室评估以及颈动脉B超检查,后者可对亚临床动脉粥样硬化进行直接且无创的评估。在颈动脉窦近端1.0厘米处对左右颈总动脉进行IMT测量,并使用专用软件计算平均IMT值。还为每位受试者计算了弗明汉姆积分。SLE患者的平均IMT值为0.73±0.12(标准差)毫米。该值显著高于(P<0.05)年龄匹配的健康女性对照人群的报告值(0.66±0.11标准差毫米)。对弗明汉姆积分的初步评估,即估计女性发生心血管事件的10年风险,表明SLE患者早期心血管事件风险增加。在我们的研究中,我们已表明SLE患者与健康女性对照组相比,平均IMT值升高。此外,对弗明汉姆积分的评估表明SLE是心血管疾病的一个额外风险因素。