Ye Yi-cong, Zeng Yong, Zhu Wen-ling, Zhao Yan, Zeng Xiao-feng, Zhang Shu-yang, Fang Quan, Li Xiao-meng
Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2008 Apr;36(4):327-31.
To analyze the cardiac manifestations of patients with primary and secondary Sjogren syndrome.
Clinical data (clinical manifestations, serologic measurements, echocardiogram) of 396 patients with Sjogren syndrome who admitted to our hospital from 2004--2007 were retrospectively analyzed. Patients with congenital, rheumatic and coronary heart diseases, hypertension and diabetes (n = 221) and patients with incomplete clinic data (n = 51) were excluded.
A total of 124 cases were included in this analysis (mean age 47.4 years old; 5 males; average disease duration 85.5 months). Cardiac involvement in Sjogren syndrome is usually asymptomatic. Pericardial effusion (PE) were evidenced in 20.2%, left ventricular diastolic dysfunction (LVDD) in 13.7%, pulmonary artery hypertension (PAH) in 12.9%, left atrium enlargement/in 7.3%, mitral insufficiency in 4.8%, aortic dilation in 5.6%, tricuspid insufficiency in 3.2%, left ventricular enlargement in 2.4% and left ventricular systolic dysfunction in 0.8% patients by echocardiography examinations. Patients with PE had significantly lower CH50, C3, C4 levels and significantly higher C reactive protein level (CRP) and SSA positive rate than patients without PE (all P < 0.05). The serum level of CRP was significantly associated with PE (OR 0.976, 95% CI 0.956 - 0.997, P < 0.05). Age is positively correlated to LVDD (OR 0.884, 95% CI 0.811 - 0.964, P < 0.005). The gammaglobulin level is significantly higher in the PAH group than that in the non-PAH group (P < 0.05).
Cardiac involvement is not rare in patients with Sjogren syndrome. PE, LVDD and PAH are usual cardiac manifestations in these patients. The serum level of CRP is positively related to PE in these patients with Sjogren syndrome.
分析原发性和继发性干燥综合征患者的心脏表现。
回顾性分析2004年至2007年我院收治的396例干燥综合征患者的临床资料(临床表现、血清学检测、超声心动图)。排除患有先天性、风湿性和冠状动脉心脏病、高血压和糖尿病的患者(n = 221)以及临床资料不完整的患者(n = 51)。
本分析共纳入124例患者(平均年龄47.4岁;男性5例;平均病程85.5个月)。干燥综合征患者的心脏受累通常无症状。超声心动图检查显示,20.2%的患者有心包积液(PE),13.7%的患者有左心室舒张功能障碍(LVDD),12.9%的患者有肺动脉高压(PAH),7.3%的患者有左心房扩大,4.8%的患者有二尖瓣关闭不全,5.6%的患者有主动脉扩张,3.2%的患者有三尖瓣关闭不全,2.4%的患者有左心室扩大,0.8%的患者有左心室收缩功能障碍。有PE的患者的CH50、C3、C4水平显著低于无PE的患者,C反应蛋白水平(CRP)和SSA阳性率显著高于无PE的患者(所有P < 0.05)。血清CRP水平与PE显著相关(OR 0.976,95% CI 0.956 - 0.997,P < 0.05)。年龄与LVDD呈正相关(OR 0.884,95% CI 0.811 - 0.964,P < 0.005)。PAH组的γ球蛋白水平显著高于非PAH组(P < 0.05)。
干燥综合征患者的心脏受累并不罕见。PE、LVDD和PAH是这些患者常见的心脏表现。在这些干燥综合征患者中,血清CRP水平与PE呈正相关。