系统性红斑狼疮和狼疮性肾炎中心血管疾病发病率及心血管疾病死亡率的风险：一项基于丹麦全国人口的队列研究。
The risk of cardiovascular morbidity and cardiovascular mortality in systemic lupus erythematosus and lupus nephritis: a Danish nationwide population-based cohort study.
作者信息
Hermansen Marie-Louise, Lindhardsen Jesper, Torp-Pedersen Christian, Faurschou Mikkel, Jacobsen Søren
机构信息
Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Rigshospitalet.
Department of Cardiology, Copenhagen University Hospital, Gentofte Hospital, Copenhagen.
出版信息
Rheumatology (Oxford). 2017 May 1;56(5):709-715. doi: 10.1093/rheumatology/kew475.
OBJECTIVE
. To assess the role of LN as a risk factor for myocardial infarction (MI), stroke and cardiovascular mortality (CVM) in patients with SLE.
METHODS
. The study was conducted using individual-level data from multiple nationwide registers. We identified a cohort of patients diagnosed with SLE and further determined if they had a diagnosis of LN during 1995-2011. Each SLE patient was matched with five population controls. Hazard ratios (HRs) were calculated to measure the risk of MI, stroke and CVM in SLE patients relative to population controls and in SLE patients with relative to without LN.
RESULTS
. We identified 1644 SLE patients with incident SLE; 233 of these patients had a diagnosis of incident LN during follow-up. The number of events in the SLE cohort was: 42 (MI), 74 (stroke) and 56 (CVM). For MI, the HR was 2.2 (95% CI: 1.4, 3.4) in SLE without LN and 18.3 (95% CI: 5.1, 65) in SLE with LN. The HR for LN was 8.5 (95% CI: 2.2, 33; P = 0.002). For stroke, HRs were 2.1 (95% CI: 1.5, 2.9) and 4.1 (95% CI: 1.9, 8.7) in SLE without and with LN, respectively, and we found no significant association with LN (P = 0.115). For CVM, the respective HRs were 1.6 (95% CI: 1.1, 2.4) and 7.8 (95% CI: 3.0, 20). The corresponding HR for LN was 4.9 (95% CI: 1.8, 13.7; P = 0.002).
CONCLUSION
. The risk of MI and CVM, but not of stroke, is significantly higher in SLE patients with LN than SLE patients without LN.
目的
评估狼疮性肾炎（LN）作为系统性红斑狼疮（SLE）患者发生心肌梗死（MI）、中风和心血管疾病死亡率（CVM）风险因素的作用。
方法
本研究使用来自多个全国性登记处的个体水平数据进行。我们确定了一组被诊断为SLE的患者，并进一步确定他们在1995年至2011年期间是否被诊断为LN。每位SLE患者与五名人群对照进行匹配。计算风险比（HRs）以衡量SLE患者相对于人群对照以及有LN的SLE患者相对于无LN的SLE患者发生MI、中风和CVM的风险。
结果
我们确定了1644例新发SLE患者；其中233例患者在随访期间被诊断为新发LN。SLE队列中的事件数量为：42例（MI）、74例（中风）和56例（CVM）。对于MI，无LN的SLE患者的HR为2.2（95%置信区间：1.4，3.4），有LN的SLE患者的HR为18.3（95%置信区间：5.1，65）。LN的HR为8.5（95%置信区间：2.2，33；P = 0.002）。对于中风，无LN和有LN的SLE患者的HR分别为2.1（95%置信区间：1.5，2.9）和4.1（95%置信区间：1.9，8.7），并且我们发现与LN无显著关联（P = 0.115）。对于CVM，相应的HR分别为1.6（95%置信区间：1.1，2.4）和7.8（95%置信区间：3.0，20）。LN的相应HR为4.9（95%置信区间：1.8，13.7；P = 0.002）。
结论
有LN的SLE患者发生MI和CVM的风险显著高于无LN的SLE患者，但中风风险并非如此。
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