Chartash E K, Lans D M, Paget S A, Qamar T, Lockshin M D
Department of Medicine, Hospital for Special Surgery, New York, New York 10021.
Am J Med. 1989 Apr;86(4):407-12. doi: 10.1016/0002-9343(89)90337-9.
PURPOSE, PATIENTS, AND METHODS: Heart disease has not been well characterized in patients with systemic lupus erythematosus (SLE) and the antiphospholipid syndrome. During a prospective study of cerebrovascular disease in autoimmune disease and SLE, 11 lupus patients were identified with an antiphospholipid syndrome characterized by significant cardiac valvular disease in addition to cerebral infarction, deep vein thromboses, and thrombocytopenia. Patients were reviewed for criteria for systemic lupus and underwent echocardiographic studies and measurements of anticardiolipin antibodies, VDRL, and the lupus anticoagulant.
Eight of the 11 patients had aortic insufficiency, two of whom had associated mitral regurgitation. Three patients had mitral regurgitation alone. Microscopic analysis of a surgically excised aortic valve indicated typical Libman-Sacks verrucous endocarditis. Infective endocarditis was ruled out in all patients.
This report expands previous descriptions of antiphospholipid syndromes by describing a subset of lupus patients with significant aortic and mitral valvulitis in addition to circulating antiphospholipid antibodies, thrombocytopenia, and recurrent thromboses.
目的、患者与方法：系统性红斑狼疮（SLE）和抗磷脂综合征患者的心脏病情况尚未得到充分描述。在一项针对自身免疫性疾病和SLE患者的脑血管疾病前瞻性研究中，发现11名狼疮患者患有抗磷脂综合征，其特征除了脑梗死、深静脉血栓形成和血小板减少外，还伴有严重的心脏瓣膜疾病。对患者进行了系统性红斑狼疮标准评估，并进行了超声心动图检查以及抗心磷脂抗体、性病研究实验室玻片试验（VDRL）和狼疮抗凝物检测。
11名患者中有8名患有主动脉瓣关闭不全，其中2名伴有二尖瓣反流。3名患者仅患有二尖瓣反流。对手术切除的主动脉瓣进行显微镜分析显示为典型的Libman - Sacks疣状心内膜炎。所有患者均排除感染性心内膜炎。
本报告通过描述一组狼疮患者，除了循环抗磷脂抗体、血小板减少和复发性血栓形成外，还伴有严重的主动脉和二尖瓣瓣膜炎，扩展了先前对抗磷脂综合征的描述。
