Hamdani Muhammad Afzal, Saud Al-Arfaj Abdul Rahman, Parvez Khalid, Naseeb Faisal, Ibrahim Abdalla El Fateh, Cal Joseph Hope
Muhammad Afzal Hamdani, FCPS, Dip-Card., MRCP. Senior Registrar, Division of Rheumatology, Department of Medicine, King Khalid University Hospital (KKUH), King Saud University (KSU), Riyadh, Saudi Arabia.
Abdul Rahman Saud Al-Arfaj, MRCP(UK), FRCPC, Professor of Rheumatology, American Board of Internal Medicine, American Board of Rheumatology. Department of Medicine, King Khalid University Hospital (KKUH), King Saud University (KSU), Riyadh, Saudi Arabia.
Pak J Med Sci. 2015 Jan-Feb;31(1):70-5. doi: 10.12669/pjms.311.6544.
To uncover the pulmonary manifestations of Systemic Lupus Erythematosus (SLE) patients alone and to compare findings with antiphospholipid syndrome (APS) associated with SLE.
This cross sectional comparative study was carried out at King Khalid University Hospital (KKUH)/King Saud University (KSU), a tertiary care hospital, Riyadh, Kingdom of Saudi Arabia. From June 2012 to March 2014, 96 diagnosed SLE patients with respiratory symptoms were included in the study and divided into two groups. Group one included SLE without antiphospholipid syndrome (APS) and group two SLE with APS. We compared Demographic features, clinical manifestations and findings of chest X-Ray, Arterial Blood Gases, Pulmonary function tests, six minute walk test, ventilation perfusion scan, echocardiography and chest high resolution computed tomography.
Demographic and clinical characteristics of two groups were similar. Previous history of deep venous thrombosis (3% vs 27.6%, p=0.001), pulmonary embolism (3% vs34.5%, p<0.0001) and abortions (7.5% vs 27.6%, p=0.019) were significantly more in group two. Levels of Anticardiolipin antibody (0% vs 100%, p<0.0001) and lupus anticoagulant (1.5% vs 79.3%, p<0.0001) were also significantly higher in group two. Hypoxemia measured by pulse oximetry (43.3% vs 65.5% p=0.045, pulmonary Arterial Hypertension (15.5% vs 39.3% p=0.014)), and pulmonary embolism (3.4% vs 21.4% p=0.013) and ventilation perfusion mismatch on V/Q scan (1.5% vs 24.1% p=0.001) were more frequent in group two.
Hypoxemia, pulmonary embolism and pulmonary arterial hypertension were significantly high in SLE patients with APS, requiring long term anticoagulation and treatment and close follow-up.
揭示单纯系统性红斑狼疮（SLE）患者的肺部表现，并将结果与伴发抗磷脂综合征（APS）的SLE患者进行比较。
本横断面比较研究在沙特阿拉伯王国利雅得的三级医疗机构哈利德国王大学医院（KKUH）/沙特国王大学（KSU）开展。2012年6月至2014年3月，96例有呼吸道症状的确诊SLE患者纳入研究并分为两组。第一组为不伴有抗磷脂综合征（APS）的SLE患者，第二组为伴有APS的SLE患者。我们比较了人口统计学特征、临床表现以及胸部X线、动脉血气、肺功能测试、六分钟步行试验、通气灌注扫描、超声心动图和胸部高分辨率计算机断层扫描的结果。
两组的人口统计学和临床特征相似。第二组患者深静脉血栓形成既往史（3% 对27.6%，p = 0.001）、肺栓塞既往史（3% 对34.5%，p < 0.0001）和流产既往史（7.5% 对27.6%，p = 0.019）显著更多。第二组抗心磷脂抗体水平（0% 对100%，p < 0.0001）和狼疮抗凝物水平（1.5% 对79.3%，p < 0.0001）也显著更高。通过脉搏血氧饱和度测定的低氧血症（43.3% 对65.5%，p = 0.045）、肺动脉高压（15.5% 对39.3%，p = 0.014）、肺栓塞（3.4% 对21.4%，p = 0.013）以及通气灌注扫描的通气灌注不匹配（1.5% 对24.1%，p = 0.001）在第二组中更常见。
伴有APS的SLE患者中低氧血症、肺栓塞和肺动脉高压显著高发，需要长期抗凝治疗及密切随访。
