Toda R, Yuda T, Nishida T, Matsumoto H, Moriyama Y, Taira A
Department of Cardiovascular Surgery, Miyazaki Prefectural Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1997 Jun;45(6):919-22.
A 46-year-old woman was hospitalized for aortic valve stenosis (AS) associated with systemic lupus erythematosus (SLE) on April 12, 1996. She had a syncopal episode six months before admission. She was found to have thrombocytopenia, and was diagnosed with SLE by further examination. Irregular genital bleeding was also seen on admission while her SLE was being controlled with steroid therapy. Aortic valve replacement was performed after the steroids had been reduced to avoid excessive bleeding. The aortic valve was the bicuspid with raphe. There was much calcification on the cusps and the annulus, but there were no degenerative changes. The postoperative course was uneventful, and her SLE has been in remission two years after the operation. The management of steroid therapy for SLE patients complicated with cardiovascular disease is discussed.
一名46岁女性于1996年4月12日因与系统性红斑狼疮(SLE)相关的主动脉瓣狭窄(AS)住院。入院前六个月她曾发生过一次晕厥。她被发现有血小板减少症,经进一步检查诊断为SLE。入院时,在使用类固醇疗法控制其SLE的同时,还发现有不规则生殖器出血。为避免过度出血,在类固醇减量后进行了主动脉瓣置换术。主动脉瓣为二叶式且有瓣缝。瓣叶和瓣环有大量钙化,但无退行性改变。术后过程顺利,术后两年她的SLE一直处于缓解状态。本文讨论了合并心血管疾病的SLE患者的类固醇疗法管理。