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系统性红斑狼疮相关肺动脉高压:中国人群 642 例的系统性综述和分析。

Pulmonary hypertension in systemic lupus erythematosus: a systematic review and analysis of 642 cases in Chinese population.

机构信息

Department of Integrated Chinese and Western Medicine, Tongji Hospital of Tongji Medical College, Central-China (Huazhong) University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, Hubei, People's Republic of China.

出版信息

Rheumatol Int. 2013 May;33(5):1211-7. doi: 10.1007/s00296-012-2525-y. Epub 2012 Sep 16.

Abstract

Pulmonary hypertension (PH) is an increasingly recognized complication of systemic lupus erythematosus (SLE). To develop a more comprehensive understanding of the clinical and pathological characteristics of pulmonary hypertension associated with systemic lupus erythematosus (PH/SLE) in the Chinese population, a systematic review of the literature up to 2012 was conducted. Six hundred and forty-two Chinese PH/SLE cases from 22 studies were identified as well documented and further analyzed. Transthoracic echocardiography (TTE), X-ray, electrocardiogram and right heart catheterization (RHC) were performed to diagnose PH in SLE patients. The mean age of subjects was 35.5 years, the male to female ratio was 1:14, and the mean duration of SLE when PH was diagnosed was 10.7 years. The prevalence of PH in SLE was 2.8-23.3 %. Symptoms were usually nonspecific, and the observed clinical characteristics include Raynaud's phenomenon (41.4 %), serous effusion (27.7 %), positive RNP (51.5 %) and positive ACL (46.6 %). Gold standard RHC is strongly recommended, especially for those who had resting pulmonary arterial systolic pressure >30 mmHg on TTE with the aforementioned clinical characteristics. Corticosteroids, immunosuppressants and vasodilators were the most common medications employed in treatment. Early identification and standard PH treatment with intensive SLE treatment can improve the prognosis.

摘要

肺高血压(PH)是系统性红斑狼疮(SLE)的一种越来越被认识到的并发症。为了更全面地了解中国人系统性红斑狼疮相关肺高血压(PH/SLE)的临床和病理特征,对截至 2012 年的文献进行了系统综述。从 22 项研究中确定了 642 例有详细记录的中国 PH/SLE 病例,并对其进行了进一步分析。经胸超声心动图(TTE)、X 射线、心电图和右心导管检查(RHC)用于诊断 SLE 患者的 PH。受试者的平均年龄为 35.5 岁,男女比例为 1:14,PH 诊断时 SLE 的平均病程为 10.7 年。SLE 中 PH 的患病率为 2.8-23.3%。症状通常是非特异性的,观察到的临床特征包括雷诺现象(41.4%)、浆液性渗出(27.7%)、阳性 RNP(51.5%)和阳性 ACL(46.6%)。强烈推荐采用金标准 RHC,特别是对于那些 TTE 上有上述临床特征且静息肺动脉收缩压>30mmHg 的患者。皮质类固醇、免疫抑制剂和血管扩张剂是最常用的治疗药物。早期识别和标准 PH 治疗与强化 SLE 治疗相结合可以改善预后。

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