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评估青少年系统性红斑狼疮(jSLE)患者的肺动脉压。

Evaluation of pulmonary artery pressure in patients with juvenile systemic lupus erythematosus (jSLE).

机构信息

Department of Pediatric Rheumatology, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.

出版信息

Bosn J Basic Med Sci. 2018 Feb 20;18(1):66-71. doi: 10.17305/bjbms.2017.2178.

Abstract

Juvenile systemic lupus erythematosus (jSLE) is a chronic multisystemic autoimmune disease. Previous studies among adults have shown impaired right ventricular (RV) function in patients with SLE. Also, these patients may develop pulmonary artery hypertension (PAH), which is one of the most threatening complications of SLE. Nevertheless, studies on PAH among jSLE patients are still rare. The aim of this study was to assess the RV function in jSLE patients by Doppler echocardiography (Echo Doppler). We also estimated pulmonary artery systolic pressure (PASP) and mean pulmonary artery pressure (mPAP) in these patients. A total of 38 jSLE patients and 40 sex- and age-matched controls were retrospectively analyzed. All patients underwent combined M-mode, cross-sectional echo, and Doppler Echo examination. The RV function was significantly impaired in jSLE patients compared to controls. PASP and mPAP were normal in 37 out of 38 patients (97.37%), however, the mean values of PASP and mPAP were significantly higher in jSLE patients compared to controls (26.90 mmHg versus 21.71 mmHg and 12.63 mmHg versus 9.89 mmHg, respectively) [p < 0.05]. Only one patient (2.6 %) had elevated mPAP (60 mmHg). The right cardiac catheterization confirmed PAH in this patient. Although PAH was detected only in one patient, there was a marked increase of PAP in our jSLE patients. Overall, PASP and mPAP were significantly higher in jSLE patients compared to healthy controls. Prospective studies with ethnically diverse cohorts could give more insight on the relevance of PAP and PHT in patients with jSLE.

摘要

儿童系统性红斑狼疮(jSLE)是一种慢性多系统自身免疫性疾病。以前的成人研究表明,SLE 患者的右心室(RV)功能受损。此外,这些患者可能会发展为肺动脉高压(PAH),这是 SLE 最具威胁的并发症之一。然而,关于 jSLE 患者的 PAH 研究仍然很少。本研究旨在通过多普勒超声心动图(Echo Doppler)评估 jSLE 患者的 RV 功能。我们还估计了这些患者的肺动脉收缩压(PASP)和平均肺动脉压(mPAP)。共回顾性分析了 38 名 jSLE 患者和 40 名性别和年龄匹配的对照组。所有患者均接受了联合 M 型、切面超声和多普勒超声检查。与对照组相比,jSLE 患者的 RV 功能明显受损。38 例患者中有 37 例(97.37%)的 PASP 和 mPAP 正常,但 jSLE 患者的 PASP 和 mPAP 平均值明显高于对照组(26.90mmHg 与 21.71mmHg 和 12.63mmHg 与 9.89mmHg,分别)[p<0.05]。只有 1 名患者(2.6%)mPAP 升高(60mmHg)。右心导管检查证实该患者存在 PAH。尽管仅在 1 名患者中检测到 PAH,但我们的 jSLE 患者的 PAP 明显升高。总体而言,与健康对照组相比,jSLE 患者的 PASP 和 mPAP 明显更高。具有不同种族的前瞻性研究可以更深入地了解 jSLE 患者 PAP 和 PHT 的相关性。

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