Beijing Luhe Hospital, Capital Medical University, Beijing, China.
Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Lupus. 2023 Oct;32(11):1310-1319. doi: 10.1177/09612033231202398. Epub 2023 Sep 12.
To determine the risk factors of pulmonary arterial hypertension (PAH) related to systemic lupus erythematosus (SLE) through systematic reviews and meta-analyses.
We undertook electronic search strategies using Medline via PubMed, Embase, Web of Science, and Cochrane Library up to April 11, 2023. Study selection and data extraction were performed by 2 authors independently. We made risk of bias judgments based on the Newcastle-Ottawa Scale (NOS). Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to estimate the overall effect sizes of potential risk factors for PAH in SLE patients. Univariate and multivariate meta-regression models were used to assess the independent effects of each risk factor on PAH. Sensitivity analyses were also conducted to explore potential sources of heterogeneity.
A total of 19 articles were included in this meta-analysis, and the results showed that gender (female) [RR = 1.04, 95% CI (1.02, 1.06), = .0001], interstitial lung disease [RR = 4.36, 95% CI (2.42, 7.85), = .0001], alopecia [RR = 1.39, 95% CI (1.06, 1.83), = .017], Raynaud's phenomenon [RR = 1.83, 95% CI (1.41, 2.37), = .0001], systemic hypertension [RR = 1.30, 95% CI (1.07, 1.58), = .007], serositis [RR = 2.29, 95% CI (1.89, 2.77), = .0001], pericardial effusion [RR = 3.33, 95% CI (2.20, 5.05), = .0001], anti-RNP [RR = 1.86, 95% CI (1.19, 2.91), = .006], anti-SSA [RR = 1.28, 95% CI (1.01, 1.62), = .041], anti-SSB [RR = 1.38, 95% CI (1.19, 1.60), = .0001], anti-U1RNP [RR = 1.58, 95% CI (1.07, 2.34), = .023], thrombocytopenia [RR = 1.38, 95% CI (1.14, 1.68), = .001], and current smokers [RR = 2.20, 95% CI (1.19, 4.06), = .012] were all risk factors for PAH related to SLE.
PAH is a serious complication of SLE. Since prognosis of SLE patients after the occurrence of PAH is poor, routine examination should be conducted for SLE patients with PAH risk factors.
通过系统评价和荟萃分析确定与系统性红斑狼疮（SLE）相关的肺动脉高压（PAH）的危险因素。
我们通过 Medline 旗下的 PubMed、Embase、Web of Science 和 Cochrane Library 进行了电子检索策略，检索截止日期为 2023 年 4 月 11 日。由两名作者独立进行研究选择和数据提取。我们根据纽卡斯尔-渥太华量表（NOS）进行了偏倚风险判断。汇总风险比（RR）和 95%置信区间（CI）用于估计 SLE 患者中潜在 PAH 危险因素的总体效应大小。单变量和多变量荟萃回归模型用于评估每个危险因素对 PAH 的独立影响。还进行了敏感性分析以探索潜在的异质性来源。
共有 19 篇文章纳入了本次荟萃分析，结果表明，性别（女性）[RR=1.04，95%CI（1.02，1.06）， =.0001]、间质性肺病[RR=4.36，95%CI（2.42，7.85）， =.0001]、脱发[RR=1.39，95%CI（1.06，1.83）， =.017]、雷诺现象[RR=1.83，95%CI（1.41，2.37）， =.0001]、高血压[RR=1.30，95%CI（1.07，1.58）， =.007]、浆膜炎[RR=2.29，95%CI（1.89，2.77）， =.0001]、心包积液[RR=3.33，95%CI（2.20，5.05）， =.0001]、抗 RNP[RR=1.86，95%CI（1.19，2.91）， =.006]、抗 SSA[RR=1.28，95%CI（1.01，1.62）， =.041]、抗 SSB[RR=1.38，95%CI（1.19，1.60）， =.0001]、抗 U1RNP[RR=1.58，95%CI（1.07，2.34）， =.023]、血小板减少症[RR=1.38，95%CI（1.14，1.68）， =.001]和当前吸烟者[RR=2.20，95%CI（1.19，4.06）， =.012]均是 SLE 相关 PAH 的危险因素。
PAH 是 SLE 的严重并发症。由于 SLE 患者发生 PAH 后的预后较差，应定期检查有 PAH 危险因素的 SLE 患者。
