Shaharir S S, Mohamed Said M S, Kong N C T
Universiti Kebangsaan Malaysia Medical Centre.
Reumatismo. 2012 Dec 20;64(6):341-9. doi: 10.4081/reumatismo.2012.341.
To investigate the prevalence of thickened carotid intima media thickness (CIMT) and its associated risk factors in patients with lupus nephritis (LN) who were in remission.
This was a cross sectional study in which consecutive LN patients who were in remission and attending our Nephrology/SLE Clinic were included. Their demographic profile, traditional cardiovascular risk factors and treatment medications were evaluated by clinical interview and review of medical records. Carotid intima media thickness (CIMT) was measured using B Mode carotid ultrasonography. CIMT was considered to be abnormally thickened if it exceeded the 75th percentile matched for age-and sex-matched normal controls. The associated factors for thickened CIMT were examined.
A total of 39 patients with a mean remission duration of 29 ± 24.3 months and on a mean prednisolone dose of 9.10 ± 7.83 mg daily completed the study. Six patients (15.4%) had thickened CIMT. On univariate analysis, male gender, patient age, older age at diagnosis, higher serum CRP levels, greater proteinuria and higher mean cumulative azathioprine dose were associated with thickened CIMT (P<0.05). Lower mean cumulative doses of cyclosporine A (CyA) and mycophenolic acid (MPA) (P<0.05) each were associated with thickened CIMT. Using regression analysis, the associated factors of CIMT were older age at diagnosis and proteinuria.
Lupus factors particularly age at diagnosis and proteinuria were the associated factors of thickened CIMT. Larger prospective trials are indicated to confirm our findings.
调查缓解期狼疮性肾炎（LN）患者颈动脉内膜中层厚度（CIMT）增厚的患病率及其相关危险因素。
这是一项横断面研究，纳入了连续就诊于我们肾脏病/系统性红斑狼疮诊所的缓解期LN患者。通过临床访谈和病历审查评估他们的人口统计学特征、传统心血管危险因素和治疗药物。使用B型颈动脉超声测量颈动脉内膜中层厚度（CIMT）。如果CIMT超过年龄和性别匹配的正常对照组的第75百分位数，则认为其增厚异常。检查CIMT增厚的相关因素。
共有39例患者完成了研究，平均缓解期为29±24.3个月，平均每日泼尼松龙剂量为9.10±7.83mg。6例患者（15.4%）CIMT增厚。单因素分析显示，男性、患者年龄、诊断时年龄较大、血清CRP水平较高、蛋白尿较多以及平均累积硫唑嘌呤剂量较高与CIMT增厚相关（P<0.05）。环孢素A（CyA）和霉酚酸（MPA）的平均累积剂量较低（P<0.05）均与CIMT增厚相关。使用回归分析，CIMT的相关因素为诊断时年龄较大和蛋白尿。
狼疮因素尤其是诊断时年龄和蛋白尿是CIMT增厚的相关因素。需要更大规模的前瞻性试验来证实我们的发现。
