Gabrielli F, Alcini E, Di Prima M A, Mazzacurati G, Masala C
Department of Cardiovascular and Respiratory Sciences, University La Sapienza, Rome, Italy.
Int J Cardiol. 1995 Sep;51(2):117-26. doi: 10.1016/0167-5273(95)02357-3.
The aim of this study was to determine the prevalence of cardiac valve disease in systemic lupus erythematosus or in patients with primary antiphospholipid syndrome and to assess the role of the antiphospholipid antibodies as risk factor for endocardial lesions. We studied 39 consecutive patients with systemic lupus erythematosus (mean age 34 +/- 12 years, 38 female and one male), 20 women with primary antiphospholipid syndrome (mean age 32 +/- 4 years) and 20 normal subjects (mean age 35 +/- 8 years, 15 female and five male). All patients with primary antiphospholipid syndrome had increased levels of serum anticardiolipin antibodies and recurrent fetal abortions; some of them also had arterial and/or venous thrombosis and/or thrombocytopenia. M-mode, two-dimensional and Doppler echocardiography were performed in all patients. IgG anticardiolipin antibodies were measured by an enzyme-linked immunosorbent assay. Valvular lesions were observed in 15 patients (38%) with systemic lupus erythematosus. These abnormalities included: mitral valve thickening or vegetation, mitral valve prolapse and aortic valve vegetation; mitral, aortic and tricuspid regurgitation; mitral stenosis. None of the patients with primary antiphospholipid syndrome and of the normal subjects was found to have valvular abnormalities. In systemic lupus erythematosus, high levels of anticardiolipin antibodies were detected in 73% of the patients with valvular lesions and in 67% of the patients without valvular lesions (P > 0.05). We conclude that valvular involvement is frequent in patients with systemic lupus erythematosus but it is apparently unrelated to antiphospholipid autoimmunization.
本研究的目的是确定系统性红斑狼疮或原发性抗磷脂综合征患者中心脏瓣膜病的患病率，并评估抗磷脂抗体作为心内膜病变危险因素的作用。我们研究了39例连续的系统性红斑狼疮患者（平均年龄34±12岁，38例女性和1例男性）、20例原发性抗磷脂综合征女性患者（平均年龄32±4岁）以及20例正常受试者（平均年龄35±8岁，15例女性和5例男性）。所有原发性抗磷脂综合征患者血清抗心磷脂抗体水平升高且有反复的胎儿流产；其中一些患者还患有动脉和/或静脉血栓形成和/或血小板减少症。对所有患者均进行了M型、二维和多普勒超声心动图检查。采用酶联免疫吸附测定法检测IgG抗心磷脂抗体。在15例（38%）系统性红斑狼疮患者中观察到瓣膜病变。这些异常包括：二尖瓣增厚或赘生物、二尖瓣脱垂和主动脉瓣赘生物；二尖瓣、主动脉瓣和三尖瓣反流；二尖瓣狭窄。原发性抗磷脂综合征患者和正常受试者均未发现瓣膜异常。在系统性红斑狼疮患者中，73%有瓣膜病变的患者和67%无瓣膜病变的患者检测到高水平的抗心磷脂抗体（P>0.05）。我们得出结论，瓣膜受累在系统性红斑狼疮患者中很常见，但显然与抗磷脂自身免疫无关。
