Dai Yu-xiang, Zhang Shu-yang, DU Zhen-yan
Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Nei Ke Za Zhi. 2007 Jul;46(7):541-3.
To summarize the clinical characteristics of systemic lupus erythematosus (SLE) associated with coronary artery disease (CHD).
This is a retrospective analysis. We studied the traditional cardiovascular risk factors, first onset of cardiac events, diagnosis, treatment and activity of the disease in 11 SLE patients with CHD. The results were statistically analyzed using independent-samples test and Fisher's exact test.
(1) SLE patients with CHD had an average age of (53.9 +/- 8.1) years old. (2) The mean number of CHD risk factors per patient was 1.3 +/- 0.8. (3) The level of lipids was significantly elevated after therapy with corticosteroids (The P values for TC, LDL-C, HDL-C and TG were 0.013, 0.003, 0.016 and 0.006, respectively). (4) The SLEDAI was 12.0 +/- 10.3 when the first cardiac event happened. (5) SLE patients with CHD often had severe lesions of the coronary artery, manifested as diffuse stenosis and severe calcification.
Conventional CHD risk factors cannot fully account for premature CHD in SLE patients. SLE patients with CHD often had severe lesions of the coronary artery and poor prognosis, so we should treat it as early as possible to delay the progress of CHD and use non-invasive examinations for early diagnosis in order to improve the prognosis.
总结系统性红斑狼疮（SLE）合并冠状动脉疾病（CHD）的临床特征。
这是一项回顾性分析。我们研究了11例合并CHD的SLE患者的传统心血管危险因素、首次心脏事件发作情况、疾病诊断、治疗及活动情况。结果采用独立样本检验和Fisher确切检验进行统计学分析。
（1）合并CHD的SLE患者平均年龄为（53.9±8.1）岁。（2）每位患者CHD危险因素的平均数量为1.3±0.8。（3）使用皮质类固醇治疗后血脂水平显著升高（总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯的P值分别为0.013、0.003、0.016和0.006）。（4）首次心脏事件发生时SLE疾病活动指数（SLEDAI）为12.0±10.3。（5）合并CHD的SLE患者常出现冠状动脉严重病变，表现为弥漫性狭窄和严重钙化。
传统的CHD危险因素不能完全解释SLE患者CHD的过早发生。合并CHD的SLE患者常出现冠状动脉严重病变且预后较差，因此应尽早治疗以延缓CHD进展，并采用无创检查进行早期诊断以改善预后。
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