疾病持续时间、诊断时的年龄和器官损伤是 SLE 患者心血管疾病的重要因素。
Disease duration, age at diagnosis and organ damage are important factors for cardiovascular disease in SLE.
机构信息
Department of Rheumatology, Institution for Clinical Sciences, Lund, Sweden
Department of Rheumatology, Institution for Clinical Sciences, Lund, Sweden.
出版信息
Lupus Sci Med. 2020 Jun;7(1). doi: 10.1136/lupus-2020-000398.
OBJECTIVE
To report the incidence rate ratios (IRR) of acute myocardial infarctions (AMI) and cerebrovascular events (CVE) in incident SLE cases from a defined population. To study the risk factors for cardiovascular events in all patients with SLE at our unit.
METHODS
Patients with SLE diagnosed from 1981 to 2006 were followed through to 2016. IRRs of AMI and CVE were calculated. The AMI and CVE incidence patterns for patients with SLE were studied in relation to hypertension, smoking, renal dysfunction, anticardiolipin (aCL) antibodies at diagnosis, disease duration and organ damage before an event.
RESULTS
262 patients with SLE were included in the study; of these 175 were from the defined population. Overall, 37 AMI and 44 CVE were recorded. An increased IRR of 3 for AMI was found (p<0.001). Smoking, hypertension and reduced renal function were risk factors for AMI. An increased IRR of 3.3 for ischaemic CVE was found for women (p<0.001). Hypertension and aCL were risk factors for CVE. Organ damage before events was increased.
CONCLUSIONS
Cardiovascular events are increased in SLE and are associated with hypertension, smoking and increased damage rate.
目的
报告从特定人群中确诊的新发系统性红斑狼疮（SLE）患者中急性心肌梗死（AMI）和脑血管事件（CVE）的发生率比值（IRR）。研究本单位所有 SLE 患者发生心血管事件的危险因素。
方法
随访了 1981 年至 2006 年确诊的 SLE 患者，直至 2016 年。计算了 AMI 和 CVE 的 IRR。研究了 SLE 患者的 AMI 和 CVE 发病模式与高血压、吸烟、肾功能不全、诊断时抗心磷脂（aCL）抗体、疾病持续时间和事件前器官损伤之间的关系。
结果
本研究共纳入 262 例 SLE 患者，其中 175 例来自特定人群。共记录到 37 例 AMI 和 44 例 CVE。发现 AMI 的 IRR 增加了 3 倍（p<0.001）。吸烟、高血压和肾功能减退是 AMI 的危险因素。女性缺血性 CVE 的 IRR 增加了 3.3 倍（p<0.001）。高血压和 aCL 是 CVE 的危险因素。事件前的器官损伤增加。
结论
SLE 患者的心血管事件增加，与高血压、吸烟和增加的损伤率有关。
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