Cacciapaglia F, Zardi E M, Coppolino G, Buzzulini F, Margiotta D, Arcarese L, Vadacca M, Amoroso A, Afeltra A
Department of Clinical Medicine, "Campus Bio-Medico" University of Rome, Rome, Italy
Lupus. 2009 Mar;18(3):249-56. doi: 10.1177/0961203308097571.
Detection of early carotid vascular disease in patients with systemic lupus erythematosus (SLE) is considered mandatory for evaluation of subclinical atherosclerosis (ATS), and various ultrasonographic (US) parameters have been proposed. In the present investigation, 33 SLE and 33 healthy age-matched females have been studied by colour-coded sonography of the common carotid artery, assessing intima-media thickness (IMT), vascular strain (VS), vascular distensibility (VD), vascular stiffness (VSf) and pressure-strain elastic modulus (PSEM) as possible markers of early ATS. Patients with SLE, despite equivalent exposure to "traditional" cardiovascular risk factors, presented a higher mean IMT of the common carotid artery than healthy subjects (0.7 +/- 0.2 mm vs 0.5 +/- 0.1 mm - P < 0.0001). Of the stiffness parameters, patients with lupus showed a mean VSf of 0.72 +/- 0.38 vs 0.54 +/- 0.14 in controls (P < 0.0001) and a mean PSEM of 6.0 +/- 2.8 Pa vs 3.0 +/- 1.4 Pa in controls (P < 0.0001). Mean VS and VD were significantly lower in patients with SLE than in healthy subjects (P < 0.0001). Among individuals with IMT < 0.6 mm, patients with SLE presented more compromised stiffness parameters. IMT was shown to be a useful parameter in the evaluation of vascular damage, even in a "sub-clinical" phase, while stiffness parameters provide additional details regarding endothelial and vessel functional state. Combined evaluation may allow ATS to be detected in the early stages in patients with SLE.
检测系统性红斑狼疮（SLE）患者的早期颈动脉血管疾病被认为是评估亚临床动脉粥样硬化（ATS）的必要手段，并且已经提出了各种超声（US）参数。在本研究中，通过对颈总动脉进行彩色编码超声检查，对33例SLE患者和33例年龄匹配的健康女性进行了研究，评估内膜中层厚度（IMT）、血管应变（VS）、血管扩张性（VD）、血管僵硬度（VSf）和压力应变弹性模量（PSEM）作为早期ATS的可能标志物。尽管SLE患者暴露于“传统”心血管危险因素的情况相当，但他们颈总动脉的平均IMT高于健康受试者（0.7±0.2mm对0.5±0.1mm - P<0.0001）。在僵硬度参数方面，狼疮患者的平均VSf为0.72±0.38，而对照组为0.54±0.14（P<0.0001），平均PSEM为6.0±2.8Pa，而对照组为3.0±1.4Pa（P<0.0001）。SLE患者的平均VS和VD显著低于健康受试者（P<0.0001）。在IMT<0.6mm的个体中，SLE患者的僵硬度参数受损更严重。IMT被证明是评估血管损伤的一个有用参数，即使在“亚临床”阶段也是如此，而僵硬度参数提供了有关内皮和血管功能状态的更多细节。联合评估可能有助于在SLE患者的早期阶段检测出ATS。
