Department of General Medicine, SRM Medical College Hospital & Research Centre, SRM IST, Kattankulathur, India.
Division of Medical Research, SRM Medical College Hospital & Research Centre, SRM IST, Kattankulathur, India.
Lupus. 2024 Oct;33(11):1220-1226. doi: 10.1177/09612033241274599. Epub 2024 Aug 18.
Systemic Lupus Erythematosus (SLE) is an autoimmune disease having a variety of clinical symptoms because of multiple organs being affected at once or progressively over time. Cardiovascular system (CVS) involvement is the third most frequent cause of death in SLE, among other factors. The prognosis can be determined by looking at QT interval measurements, which have shown an elevated risk of mortality from cardiovascular causes.
A case-control study was conducted on 80 patients (40 SLE patients and 40 controls) for a duration of 16 months. SLE patients and controls were identified from the general medicine and rheumatology outpatient department (OPD) based on the inclusion criteria. A thorough clinical examination was performed after obtaining a detailed clinical history. Baseline blood tests were then performed on the SLE patients and ECG was taken from both cases and controls. The serum uric acid level was measured using an automated analyzer, and the ESR was computed using Westergren's Method. The corrected QT interval (QTc) was estimated using Bazett's method. All the collected data were compared and analyzed using IBM SPSS Statistics version 23.0.
The majority of age distribution among SLE patients and controls was 21-25 years (37.5%) (Mean - 15.7 ± 14.9 years). Duration of SLE was predominantly reported between 1 and 12 months (62.5%). Very high (40%) and high (40%) lupus disease activity was recorded in the majority as per the SELENA-SLEDAI score. There was a significant difference between QTc values among SLE patients and controls (t- 8.117) (-.0005). Upon correlating SLEDAI with the QTc, QTd, ESR, and Uric acid parameters among the SLE patients, ESR parameters were found to be moderately correlated (r-0.460) with the SLEDAI which was statistically significant (- .003).
QTc interval and ESR values can be a simple and potential method for early detection of cardiac involvement in SLE patients with active disease activity. This will not only facilitate early diagnosis of disease activity, but it will also provide an affordable and accessible avenue for low and middle-income countries to decrease the SLE burden.
红斑狼疮(SLE)是一种自身免疫性疾病,由于多个器官同时或随着时间的推移逐渐受到影响,会出现多种临床症状。心血管系统(CVS)受累是 SLE 患者死亡的第三大常见原因,除此之外还有其他因素。QT 间期测量可以预测心血管原因导致的死亡率升高,因此可以根据这一测量结果来判断预后。
本病例对照研究共纳入 80 名患者(40 名 SLE 患者和 40 名对照),持续时间为 16 个月。SLE 患者和对照均从综合医学和风湿病门诊(OPD)根据纳入标准中识别。在获得详细的临床病史后,对所有患者进行全面的临床检查。然后对 SLE 患者进行基线血液检查,并对所有病例和对照进行心电图检查。使用自动分析仪测量血清尿酸水平,使用 Westergren 法计算 ESR。使用 Bazett 法估计校正 QT 间期(QTc)。使用 IBM SPSS Statistics 版本 23.0 对所有收集的数据进行比较和分析。
SLE 患者和对照的年龄分布主要在 21-25 岁(37.5%)(平均年龄为 15.7 ± 14.9 岁)。SLE 的发病时间主要报告为 1-12 个月(62.5%)。根据 SELENA-SLEDAI 评分,大多数 SLE 患者的疾病活动度非常高(40%)和高(40%)。SLE 患者的 QTc 值与对照组有显著差异(t=-8.117,-0.0005)。在将 SLEDAI 与 SLE 患者的 QTc、QTd、ESR 和尿酸参数进行相关分析时,发现 ESR 参数与 SLEDAI 呈中度相关(r=0.460),且具有统计学意义(-.003)。
在疾病活动期,QTc 间期和 ESR 值可作为一种简单、有潜力的方法,用于早期检测 SLE 患者的心脏受累情况。这不仅有助于早期诊断疾病活动度,而且为中低收入国家提供了一种负担得起且易于获得的途径,以降低 SLE 的负担。