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系统性红斑狼疮中肺动脉高压的超声心动图表现与六分钟步行试验及血浆前B型利钠肽水平的相关性

Correlation of echocardiographic findings of pulmonary hypertension with six-minute walk test and plasma pro b-type natriuretic peptide level in systemic lupus erythematous.

作者信息

Ghofraniha Leila, Mirfeizi Zahra, Khabbaz Fatemeh Seyyedi, Vakilian Farveh, Eslami Saeed

机构信息

Pulmonologist, Lung Disease Research Center, School of Medicine, Mashhad University of Medicine Sciences, Mashhad, Iran.

MD, Associate Professor of Rheumatology, Rheumatic Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Electron Physician. 2017 Aug 1;9(8):5122-5128. doi: 10.19082/5122. eCollection 2017 Aug.

Abstract

INTRODUCTION

Pulmonary arterial hypertension (PAH) is an increasingly recognized complication of systemic lupus erythematous (SLE), which may remain undiagnosed if asymptomatic.

OBJECTIVE

This study aimed to determine the correlation between echocardiographic findings of PAH and six-minute walk test (6WMT) and serum pro b-type natriuretic peptide (proBNP) level in patients with SLE.

METHODS

This cross-sectional study was performed on 50 SLE patients selected from patients referring to the outpatient's department of the Rheumatology Clinic at Imam Reza Hospital in Mashhad, Iran, from July 2013 through September 2014, using resting transthoracic echocardiography to estimate systolic pulmonary artery pressure (sPAP). Variables were summarized as counts and/or percentages or as mean±SD. Inter-group comparisons were made performing two-tailed Fisher's exact test or Mann-Whitney U test, using SPSS 22.

RESULTS

In general, five out of fifty patients were diagnosed to have PAH with sPAP>30 mmHg (range: 31-40 mmHg) based on echocardiographic findings. Spirometric parameters did not show any differences between the two groups (p>0.05), while the difference in total distance walked during six minutes and serum proBNP level between SLE patients with and without PAH was significant (P<0.05). A high correlation was found between PAP and serum proBNP level, but not between PAP and the distance walked during six-minutes in SLE patients.

CONCLUSION

The point prevalence of PAH in SLE patients was 10%; the significant correlation between PAP and serum proBNP level suggests that it can be used as a valuable marker for early diagnosis of asymptomatic pulmonary hypertension in patients with SLE.

摘要

引言

肺动脉高压(PAH)是系统性红斑狼疮(SLE)一种越来越被认识到的并发症,如果无症状可能仍未被诊断。

目的

本研究旨在确定SLE患者PAH的超声心动图表现与六分钟步行试验(6WMT)及血清前B型利钠肽(proBNP)水平之间的相关性。

方法

本横断面研究于2013年7月至2014年9月在伊朗马什哈德伊玛目礼萨医院风湿病门诊转诊的患者中选取50例SLE患者进行,采用静息经胸超声心动图评估收缩期肺动脉压(sPAP)。变量以计数和/或百分比或均值±标准差进行总结。使用SPSS 22进行组间比较,采用双尾Fisher精确检验或Mann-Whitney U检验。

结果

总体而言,根据超声心动图表现,50例患者中有5例被诊断为PAH,sPAP>30 mmHg(范围:31 - 40 mmHg)。肺功能参数在两组之间未显示出任何差异(p>0.05),而有PAH和无PAH的SLE患者在六分钟内行走的总距离和血清proBNP水平差异显著(P<0.05)。在SLE患者中发现PAP与血清proBNP水平之间存在高度相关性,但PAP与六分钟内行走距离之间无相关性。

结论

SLE患者中PAH的点患病率为10%;PAP与血清proBNP水平之间的显著相关性表明,它可作为SLE患者无症状肺动脉高压早期诊断的有价值标志物。

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