Department of Rheumatology and Immunology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Int J Rheum Dis. 2022 Jan;25(1):76-82. doi: 10.1111/1756-185X.14251. Epub 2021 Nov 18.
To investigate the predictive factors of pulmonary arterial hypertension (PAH) in systemic lupus erythematosus (SLE) patients.
This chart review study included 408 SLE patients. We defined PAH as 2 consecutive systolic pulmonary arterial pressure (PAP) values ≥40 mm Hg by echocardiography. Demographic characteristics, clinical symptoms, autoantibodies, and laboratory tests were studied.
Thirty-four patients in the SLE/PAH+ group and 374 patients in the SLE/PAH- group were analyzed. The prevalence of PAH in SLE is 8.3% in this study. The occurrences of interstitial pneumonitis, polyserositis and myocardial damage were higher in the SLE/PAH+ group (P = .001, P = .033 and P < .001, respectively). The occurrence of anti-double-stranded DNA and anti-ribosomal RNA protein (anti-rRNP) antibodies were lower in the SLE/PAH+ group (P = .003, .010). Positive rates of anti-Sjögren's syndrome antigen A (anti-SSA)/Ro52 antibodies and anti-SSB antibodies were higher in the SLE/PAH+ group (P = .046, .021). C-reactive protein and immunoglobin G (IgG) were higher in the SLE/PAH+ group (P = .009, .005). Ejection fraction and SLE disease activity index between the 2 groups had no differences. Multivariable logistic regression indicated that interstitial pneumonitis, myocardial damage and high IgG are predictive factors for SLE-associated PAH patients.
From this study, we found that interstitial pneumonitis, myocardial damage, and high IgG were predictive factors of PAH in SLE patients.
探讨系统性红斑狼疮(SLE)患者肺动脉高压(PAH)的预测因素。
本回顾性研究纳入了 408 例 SLE 患者。我们将超声心动图检查提示 2 次连续收缩期肺动脉压(PAP)≥40mmHg 定义为 PAH。研究了人口统计学特征、临床症状、自身抗体和实验室检查。
SLE/PAH+组 34 例患者和 SLE/PAH-组 374 例患者纳入分析。本研究中 SLE 合并 PAH 的患病率为 8.3%。SLE/PAH+组中出现间质性肺炎、多浆膜炎和心肌损伤的发生率较高(P=0.001、P=0.033 和 P<0.001)。SLE/PAH+组抗双链 DNA 和抗核糖体 RNA 蛋白(抗-rRNP)抗体的发生率较低(P=0.003、0.010)。SLE/PAH+组抗干燥综合征 A 抗原(抗-SSA)/Ro52 抗体和抗 SSB 抗体的阳性率较高(P=0.046、0.021)。SLE/PAH+组 C 反应蛋白和免疫球蛋白 G(IgG)水平较高(P=0.009、0.005)。两组间射血分数和 SLE 疾病活动指数无差异。多变量 logistic 回归表明,间质性肺炎、心肌损伤和 IgG 升高是 SLE 相关 PAH 的预测因素。
本研究发现间质性肺炎、心肌损伤和 IgG 升高是 SLE 患者发生 PAH 的预测因素。