系统性红斑狼疮患者合并动脉粥样硬化临床特点及危险因素分析
发布时间：2018-12-20 11:06
【摘要】：目的:系统性红斑狼疮(systemic lupus erythematosus,SLE)发生动脉粥样硬化(atherosclerosis,AS)的风险高于同年龄普通人群。本研究通过对在我院住院及门诊确诊的系统性红斑狼疮患者进行资料收集,分析系统性红斑狼疮患者的临床、实验室数据及药物使用情况,并应用彩色超声多普勒进行颈动脉超声检查,以探讨系统性红斑狼疮患者发生动脉粥样硬化的临床特点及危险因素,以期为早期干预动脉粥样硬化病程进展提供可靠依据。方法:本研究收集2014年4月至2015年2月在天津医科大学总医院风湿免疫科住院及门诊就诊的系统性红斑狼疮患者89例,所有患者由专人进行颈动脉彩色多普勒超声检查,并同时收集患者临床及实验室资料,临床资料包括性别、年龄、病程、身高、体重、吸烟史、高血压病史、糖尿病史、系统性红斑狼疮疾病活动度评分及糖皮质激素、羟氯喹、环磷酰胺使用情况;实验室资料包括:血总胆固醇、甘油三脂(triglyceride,TG)、高密度脂蛋白、低密度脂蛋白、血肌酐、血尿酸、血浆纤维蛋白原(fibrinogen,FIB)、血同型半胱氨酸(homocysteine,Hcy)、空腹血糖、血沉、C反应蛋白(c-reactive protein,CRP)、24小时尿蛋白定量、补体C3、免疫球蛋白G、抗双链DNA抗体定量、抗心磷脂抗体(anticardiolipin antibody,ACL)等相关血清指标。依据2010年中国高血压防治指南将双侧颈总动脉内中膜厚度㩳0.9mm的患者纳入SLE无AS组,任一侧颈总动脉内中膜厚度≥0.9mm纳入SLE有AS组。对比不同分组间患者临床、实验室资料及药物使用情况。将组间比较有统计学意义(P㩳0.05)的因素纳入多因素Logistic回归分析模型中。经多因素Logistic回归分析得到独立危险因素。从而了解SLE患者合并AS的临床特点及相关危险因素。结果:1.89例SLE中合并AS的17例,发生率为19.1%。SLE合并AS发生率随年龄增加而上升,年龄20岁患者中AS发生率为0;20-30岁患者中AS发生率为7.7%;31-40岁患者中AS发生率为16.7%;41-50岁患者中AS发生率为21.4%;50岁患者中AS发生率为72.7%。2.SLE合并AS组年龄、BMI显著高于无AS组,SLE合并AS组患者高血压发生率显著高于无AS组,提示传统AS危险因素与SLE发生AS相关。SLE合并AS组TG高于无AS组,提示SLE合并AS组存在血脂代谢异常。SLE合并AS组Hcy、FIB高于无AS组。SLE合并AS组24小时尿蛋白定量高于无AS组,提示SLE合并AS组患者肾功能受损更严重。SLE合并AS组患者的血清CRP、ACL阳性率高于无AS组。SLE合并AS组患者的SLEDAI评分显著高于无AS组患者,提示SLE合并AS组有更高的疾病活动度。SLE合并AS组中应用羟氯喹治疗的患者比例低于无AS组,提示应用羟氯喹治疗是SLE患者发生AS的保护性因素。3.年龄、SLEDAI评分是SLE合并AS的独立危险因素。结论:1.SLE合并AS发生率随年龄增加而上升。2.年龄,肥胖,高血压,SLE疾病活动,肾脏损害,TG、FIB、Hcy、CRP异常升高,ACL阳性率高及未应用羟氯喹治疗与SLE发生AS相关。3.年龄、SLE疾病活动是SLE合并AS的独立危险因素。
[Abstract]:Objective: the risk of atherosclerosis (atherosclerosis,AS) in systemic lupus erythematosus (systemic lupus erythematosus,SLE) is higher than that in the general population of the same age. In this study, the clinical, laboratory data and drug use of patients with systemic lupus erythematosus (SLE) diagnosed in our hospital and outpatient department were collected and analyzed. In order to explore the clinical characteristics and risk factors of atherosclerosis in patients with systemic lupus erythematosus (SLE), the carotid artery was examined by color Doppler ultrasound in order to provide reliable evidence for early intervention in the course of atherosclerosis. Methods: from April 2014 to February 2015, 89 patients with systemic lupus erythematosus (SLE) who were admitted to the Department of Rheumatology and Immunology, Tianjin Medical University General Hospital, were collected. All patients were examined by carotid color Doppler ultrasound. Clinical and laboratory data were collected, including sex, age, course of disease, height, weight, smoking history, history of hypertension, history of diabetes, systemic lupus erythematosus disease activity score, glucocorticoid, hydroxychloroquine. Use of cyclophosphamide; Laboratory data included: total cholesterol, triglyceride (triglyceride,TG), high density lipoprotein, low density lipoprotein, serum creatinine, serum uric acid, plasma fibrinogen (fibrinogen,FIB), blood homocysteine (homocysteine,Hcy), fasting blood glucose, Erythrocyte sedimentation rate (ESR), C-reactive protein (c-reactive protein,CRP), 24 hour urine protein quantification, complement C3, immunoglobulin G, anti-double-stranded DNA antibody, anticardiolipin antibody (anticardiolipin antibody,ACL) and so on. According to the 2010 Chinese guidelines for the prevention and treatment of hypertension, the patients with bilateral common carotid artery intima media thickness (0.9mm) were included in the SLE without AS group, and any side common carotid artery IMT 鈮，
本文编号：2387909
[Abstract]:Objective: the risk of atherosclerosis (atherosclerosis,AS) in systemic lupus erythematosus (systemic lupus erythematosus,SLE) is higher than that in the general population of the same age. In this study, the clinical, laboratory data and drug use of patients with systemic lupus erythematosus (SLE) diagnosed in our hospital and outpatient department were collected and analyzed. In order to explore the clinical characteristics and risk factors of atherosclerosis in patients with systemic lupus erythematosus (SLE), the carotid artery was examined by color Doppler ultrasound in order to provide reliable evidence for early intervention in the course of atherosclerosis. Methods: from April 2014 to February 2015, 89 patients with systemic lupus erythematosus (SLE) who were admitted to the Department of Rheumatology and Immunology, Tianjin Medical University General Hospital, were collected. All patients were examined by carotid color Doppler ultrasound. Clinical and laboratory data were collected, including sex, age, course of disease, height, weight, smoking history, history of hypertension, history of diabetes, systemic lupus erythematosus disease activity score, glucocorticoid, hydroxychloroquine. Use of cyclophosphamide; Laboratory data included: total cholesterol, triglyceride (triglyceride,TG), high density lipoprotein, low density lipoprotein, serum creatinine, serum uric acid, plasma fibrinogen (fibrinogen,FIB), blood homocysteine (homocysteine,Hcy), fasting blood glucose, Erythrocyte sedimentation rate (ESR), C-reactive protein (c-reactive protein,CRP), 24 hour urine protein quantification, complement C3, immunoglobulin G, anti-double-stranded DNA antibody, anticardiolipin antibody (anticardiolipin antibody,ACL) and so on. According to the 2010 Chinese guidelines for the prevention and treatment of hypertension, the patients with bilateral common carotid artery intima media thickness (0.9mm) were included in the SLE without AS group, and any side common carotid artery IMT 鈮，
本文编号：2387909
本文链接：https://www.wllwen.com/yixuelunwen/nfm/2387909.html
最近更新
教材专著
