Khamashta M A, Cervera R, Asherson R A, Font J, Gil A, Coltart D J, Vázquez J J, Paré C, Ingelmo M, Oliver J
Lupus Arthritis Research Unit, Rayne Institute, St Thomas' Hospital, London, UK.
Lancet. 1990 Jun 30;335(8705):1541-4. doi: 10.1016/0140-6736(90)91373-i.
A prospective echocardiographic study was carried out on 132 consecutive patients with systemic lupus erythematosus (SLE) derived from three European university medical centres. The prevalence of valvular lesions in patients with SLE was 22.7% compared with 2.9% in a control group of 68 healthy volunteers. 50 SLE patients had antibodies against phospholipids. The prevalence of valve vegetations (8/50 [16%]) and of mitral regurgitation (19/50 [38%]) was significantly higher among the SLE patients with antiphospholipids than among those without (1 and 10/82 [1.2% and 12%], respectively). During follow-up of the patients with valvular lesions, haemodynamically significant clinical valve disease developed in 6 but surgery was required in only 1; 9 had cerebrovascular occlusions; and 7 died, although no death was due directly to the cardiac involvement. Thus, valvular heart disease, particularly affecting the mitral valve, is common in patients with SLE, and the presence of antibodies against phospholipids is associated with a higher prevalence of valvular abnormalities in these patients.
对来自三个欧洲大学医学中心的132例连续性系统性红斑狼疮（SLE）患者进行了一项前瞻性超声心动图研究。SLE患者瓣膜病变的患病率为22.7%，而68名健康志愿者组成的对照组患病率为2.9%。50例SLE患者有抗磷脂抗体。有抗磷脂抗体的SLE患者中瓣膜赘生物（8/50 [16%]）和二尖瓣反流（19/50 [38%]）的患病率显著高于无抗磷脂抗体的患者（分别为1和10/82 [1.2%和12%]）。在对有瓣膜病变的患者进行随访期间，6例出现了具有血流动力学意义的临床瓣膜病，但仅1例需要手术治疗；9例发生脑血管闭塞；7例死亡，尽管没有一例死亡直接归因于心脏受累。因此，瓣膜性心脏病，尤其是累及二尖瓣的疾病，在SLE患者中很常见，并且抗磷脂抗体的存在与这些患者中瓣膜异常的较高患病率相关。
