中华风湿病学杂志
中華風濕病學雜誌
중화풍습병학잡지
CHINESE JOURNAL OF RHEUMATOLOGY
2013年
1期
16-19
,共4页
红斑狼疮,系统性%高血压,肺性%免疫抑制剂%靶向治疗
紅斑狼瘡,繫統性%高血壓,肺性%免疫抑製劑%靶嚮治療
홍반랑창,계통성%고혈압,폐성%면역억제제%파향치료
Lupus erythematosus,systemic%Hypertension,pulmonary%Immunosuppressive agents%Target treatment
目的 研究系统性红斑狼疮(SLE)合并肺动脉高压患者的临床特点和诊治现状.方法 对仁济医院风湿病科2001-2010年间住院患者进行分析随访.根据首诊心脏彩色多普勒超声估测肺动脉收缩压分为A组[≤70 mm Hg(1mm Hg=0.133 kPa)]和B组(＞70 mm Hg).用Pearson相关分析研究狼疮活动性与肺动脉高压的关系,以x2检验及Wilcoxon检验不同组别的生存曲线差异.结果 共有155例患者184次入院记录,占同期狼疮住院患者的4.16％.患者主要特点有:雷诺现象(47.3％)、心包积液(41.9％)和抗RNP抗体阳性(55.4％).随访例数为132例,47例(35.6％)患者死亡,A组9例(19.1％),B组38例(80.9％).A组患者肺动脉收缩压与狼疮活动指数呈正相关.单因素分析显示环磷酰胺(P＜0.05)和肺动脉高压靶向治疗药(P＜0.01)与疗效相关.以Logistic回归分析则仅有靶向治疗药与疗效相关(P＜0.01).应用肺高压靶向药物能显著提高重症患者的1年期生存率.结论 本病主要临床特点包括雷诺现象、心包积液和抗RNP抗体阳性.重症患者与狼疮活动性无相关性.肺动脉高压靶向药物疗效确切,环磷酰胺治疗对部分患者有效.重症患者联用环磷酰胺与肺动脉高压靶向药能显著改善预后.
目的 研究繫統性紅斑狼瘡(SLE)閤併肺動脈高壓患者的臨床特點和診治現狀.方法 對仁濟醫院風濕病科2001-2010年間住院患者進行分析隨訪.根據首診心髒綵色多普勒超聲估測肺動脈收縮壓分為A組[≤70 mm Hg(1mm Hg=0.133 kPa)]和B組(＞70 mm Hg).用Pearson相關分析研究狼瘡活動性與肺動脈高壓的關繫,以x2檢驗及Wilcoxon檢驗不同組彆的生存麯線差異.結果 共有155例患者184次入院記錄,佔同期狼瘡住院患者的4.16％.患者主要特點有:雷諾現象(47.3％)、心包積液(41.9％)和抗RNP抗體暘性(55.4％).隨訪例數為132例,47例(35.6％)患者死亡,A組9例(19.1％),B組38例(80.9％).A組患者肺動脈收縮壓與狼瘡活動指數呈正相關.單因素分析顯示環燐酰胺(P＜0.05)和肺動脈高壓靶嚮治療藥(P＜0.01)與療效相關.以Logistic迴歸分析則僅有靶嚮治療藥與療效相關(P＜0.01).應用肺高壓靶嚮藥物能顯著提高重癥患者的1年期生存率.結論 本病主要臨床特點包括雷諾現象、心包積液和抗RNP抗體暘性.重癥患者與狼瘡活動性無相關性.肺動脈高壓靶嚮藥物療效確切,環燐酰胺治療對部分患者有效.重癥患者聯用環燐酰胺與肺動脈高壓靶嚮藥能顯著改善預後.
목적 연구계통성홍반랑창(SLE)합병폐동맥고압환자적림상특점화진치현상.방법 대인제의원풍습병과2001-2010년간주원환자진행분석수방.근거수진심장채색다보륵초성고측폐동맥수축압분위A조[≤70 mm Hg(1mm Hg=0.133 kPa)]화B조(＞70 mm Hg).용Pearson상관분석연구랑창활동성여폐동맥고압적관계,이x2검험급Wilcoxon검험불동조별적생존곡선차이.결과 공유155례환자184차입원기록,점동기랑창주원환자적4.16％.환자주요특점유:뢰낙현상(47.3％)、심포적액(41.9％)화항RNP항체양성(55.4％).수방례수위132례,47례(35.6％)환자사망,A조9례(19.1％),B조38례(80.9％).A조환자폐동맥수축압여랑창활동지수정정상관.단인소분석현시배린선알(P＜0.05)화폐동맥고압파향치료약(P＜0.01)여료효상관.이Logistic회귀분석칙부유파향치료약여료효상관(P＜0.01).응용폐고압파향약물능현저제고중증환자적1년기생존솔.결론 본병주요림상특점포괄뢰낙현상、심포적액화항RNP항체양성.중증환자여랑창활동성무상관성.폐동맥고압파향약물료효학절,배린선알치료대부분환자유효.중증환자련용배린선알여폐동맥고압파향약능현저개선예후.
Objective To investigate the clinical characteristics and current condition of treatment for systemic lupus erythematosus (SLE) associated pulmonary arterial hypertension (PAH).Methods 10-year inpatients cases were reviewed and followed up.Cases were divided into 2 groups:group A:patients with baseline pulmonary arterial systolic pressure (PASP) lower than 70 mmHg； group B:patients with baseline PASP higher than 70 mm Hg.Pearson's correlation analysis,Chi-square test,Logistic regression,Cox-Mantel and Wilcoxon test were used for statistical analysis.Results There were totally 155 cases with 184 records of admission which accounted for 4.16％ among total lupus cases.The main clinical characteristics included Raynaud's phenomenon (47.3％),pericardial effusion (41.9％) and high titer of anti-RNP antibody (55.4％).There were 132 cases enrolled for prognostic statistical analysis.There were 47 cases of death (35.6％) in total,among which 9 cases (19.1％) were in group A and 38 cases (80.9％) were in group B.In group A,there was a positive correlation between PASP and lupus disease activity index score.Single therapy analysis by Chi-square test showed that cyclophosphamide (CTX) (P＜0.05) and PAH targeted drugs (P＜0.01) were significantly associated with favorable outcome but logistic regressive analysis only confirmed the efficacy of target drugs (P＜0.01).PAH target drugs significantly improved the one year survival rate of the severe cases.Conclusion The main clinical characteristics of SLE associated PAH include Raynand's phenomenon,pericardial effusion and positive anti-RNP antibody.The severity of PAH may not be related to lupus disease activity.PAH targeted drugs are effective in SLE-PAH.CTX may be effective in some cases.For severe cases,the combination therapy of CTX and PAH targeted drugs could significantly improve the prognosis.
