CAJ | 학술논문

目的：探讨无心脏临床症状的系统性红斑狼疮（SLE）患者早期左心室舒张功能减退的危险因素。方法纳入广东省梅州市人民医院风湿科无心脏临床症状的60例SLE患者及我院体检中心60例健康体检者为对照组，两组在年龄、性别、BMI、血压、心率方面相匹配。应用常规超声心动图及组织多普勒成像（TDI）对两组患者心脏进行检查，采用t检验、χ2检验分析比较两组心脏的各项参数的差异，通过多因素Logistic回归分析SLE患者早期左心室舒张功能减退的危险因素。结果与健康对照组相比，SLE患者左心室Em[（11.3±2.2）cm/s vs.（12.1±1.2）cm/s，P＝0.041]更低，E/Em更高[（8.5±2.5）cm/s vs.（7.2±2.4）cm/s，P＜0.001]，差异有统计学意义。Em＜10.0 cm/s的SLE患者的病程较长、SLEDAI评分及SLICC/ACR损伤指数较高、接受免疫抑制剂治疗的患者比例高。多因素Logistic回归分析显示病程长[OR＝4.98，95%CI（1.06，12.37），P＝0.042]、SLICC/ACR损伤指数≥1[OR＝3.68，95%CI（1.43，9.49），P＝0.007]和接受免疫抑制剂治疗[OR＝5.35，95%CI （2.30，12.46），P＜0.001]是SLE患者早期左心室舒张功能减退的危险因素。结论早期积极治疗SLE，使病情维持缓解，可降低患者心脏损害的发生率。
목적：탐토무심장림상증상적계통성홍반랑창（SLE）환자조기좌심실서장공능감퇴적위험인소。방법납입광동성매주시인민의원풍습과무심장림상증상적60례SLE환자급아원체검중심60례건강체검자위대조조，량조재년령、성별、BMI、혈압、심솔방면상필배。응용상규초성심동도급조직다보륵성상（TDI）대량조환자심장진행검사，채용t검험、χ2검험분석비교량조심장적각항삼수적차이，통과다인소Logistic회귀분석SLE환자조기좌심실서장공능감퇴적위험인소。결과여건강대조조상비，SLE환자좌심실Em[（11.3±2.2）cm/s vs.（12.1±1.2）cm/s，P＝0.041]경저，E/Em경고[（8.5±2.5）cm/s vs.（7.2±2.4）cm/s，P＜0.001]，차이유통계학의의。Em＜10.0 cm/s적SLE환자적병정교장、SLEDAI평분급SLICC/ACR손상지수교고、접수면역억제제치료적환자비례고。다인소Logistic회귀분석현시병정장[OR＝4.98，95%CI（1.06，12.37），P＝0.042]、SLICC/ACR손상지수≥1[OR＝3.68，95%CI（1.43，9.49），P＝0.007]화접수면역억제제치료[OR＝5.35，95%CI （2.30，12.46），P＜0.001]시SLE환자조기좌심실서장공능감퇴적위험인소。결론조기적겁치료SLE，사병정유지완해，가강저환자심장손해적발생솔。
Objective To investigate the risks factors of early left ventricular diastolic dysfunction in patients with systemic lupus erythematosus (SLE). Methods Sixty SLE patients without symptoms of heart involvement from Department of Rheumatology, Meizhou People’s Hospital and 60 healthy controls were involved in this study. t test and χ2 test were used for statistical analysis of the examination results of traditional echocardiography and TDI between patients and health subjects. Multivariate Logistic regression analysis was applied to investigate the risk factors for early left ventricular diastolic dysfunction. Results Compared with healthy subjects, Em was significantly lower[(11.3±2.2)cm/s vs. (12.1±1.2)cm/s, P=0.041] and E/Em was significantly higher[(8.5±2.5)cm/s vs. (7.2±2.4)cm/s, P<0.001] in SLE group. Patients with lower Em had longer disease duration, higher SLEDAI and SLICC/ACR damage index, and higher proportion of immunosuppressant therapy. The multi-factor Logistic regression analysis showed that disease duration [OR=4.98, 95% CI (1.06, 12.37), P=0.042], SLICC/ACR damage index≥1 [OR=3.68, 95% CI (1.43, 9.49), P=0.007] and immunosuppressant therapy [OR=5.35, 95% CI (2.30, 12.46), P<0.001] were risk factors for early left ventricular diastolic dysfunction. Conclusion Early aggressive treatment and maintain remission may reduce the incidence rate of heart damage in SLE patients.