Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe East Road, Zhengzhou, 450052, Henan, China.
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
Acta Neurol Belg. 2023 Dec;123(6):2177-2184. doi: 10.1007/s13760-023-02189-y. Epub 2023 Jan 31.
To investigate acute ischemic stroke (AIS) patients with systemic lupus erythematosus (SLE) clinical and imaging features, and to explore the impact of SLE on the short-term prognosis of AIS patients.
A nested case-control study was conducted in The First Affiliated Hospital of Zhengzhou University between October 1, 2019, and May 31, 2021. The case group consisted of 28 AIS patients diagnosed with SLE, and 112 AIS patients without SLE were selected by incidence density sampling as a control group.
Among 140 patients, the mean age was (48.4 ± 15.6) years, and 130 (92.9%) were females. Higher levels in low-density lipoprotein cholesterol (LDL-C) (2.5 mmol/L vs. 2.1 mmol/L; P = 0.049), D-dimer (DDi) (0.7 mg/L vs. 0.3 mg/L; P = 0.02), and C-reactive protein (CRP) (13.2 mg/L vs. 6.3 mg/L; P = 0.002) were observed in the case group. On imaging, the case group was more prevalent in simultaneous involvement of the anterior and posterior circulation (42.9% vs. 17.0%; P = 0.004), multiple infarcts (46.4% vs. 20.5%; P = 0.008) and stroke of other undetermined etiologies (SUE) (28.6% vs. 6.3%; P = 0.002) than the control group. SLE (OR 5.94, 95%CI [1.04-34.39]; P = 0.045) was an independent risk factor for a poor short-term prognosis of AIS patients.
Higher levels of LDL-C, CRP, and DDi, multiple infarcts and simultaneous involvement of the anterior, and posterior circulation were more prevalent in the AIS patients with SLE. Further, SLE was also found as an independent risk factor for AIS patients' poor short-term prognosis.
探讨系统性红斑狼疮（SLE）合并急性缺血性脑卒中（AIS）患者的临床及影像学特征，并探讨 SLE 对 AIS 患者短期预后的影响。
采用巢式病例对照研究，选取 2019 年 10 月 1 日至 2021 年 5 月 31 日郑州大学第一附属医院收治的 28 例 SLE 合并 AIS 患者为病例组，采用发病密度抽样法选取 112 例 SLE 合并 AIS 患者为对照组。
共纳入 140 例患者，平均年龄（48.4±15.6）岁，女性 130 例（92.9%）。与对照组相比，病例组患者低密度脂蛋白胆固醇（LDL-C）（2.5mmol/L 比 2.1mmol/L；P=0.049）、D-二聚体（DDi）（0.7mg/L 比 0.3mg/L；P=0.02）和 C 反应蛋白（CRP）（13.2mg/L 比 6.3mg/L；P=0.002）水平更高。在影像学方面，病例组同时累及前循环和后循环（42.9%比 17.0%；P=0.004）、多发病灶（46.4%比 20.5%；P=0.008）和其他原因不明的脑卒中（SUE）（28.6%比 6.3%；P=0.002）的比例均高于对照组。SLE（OR 5.94，95%CI [1.04-34.39]；P=0.045）是 AIS 患者短期预后不良的独立危险因素。
SLE 合并 AIS 患者 LDL-C、CRP、DDi 水平较高，多发病灶和同时累及前、后循环更为常见。此外，SLE 也是 AIS 患者短期预后不良的独立危险因素。
