| 摘要: |
| 目的 分析系统性红斑狼疮(SLE)合并急性冠脉综合征(ACS)的患者的临床特点及冠状动脉病变特征,探讨SLE合并ACS的发病机制及发病特点.方法 选择2009年5月至2013年5月在长海医院住院的年龄≥18岁的SLE患者,将其中经冠脉造影检查诊断为ACS的患者作为观察组;以2013年1月至5月长海医院收治的经冠脉造影证实的初发ACS并排除所有结缔组织疾病的患者作为对照组.对两组的传统冠心病危险因素、初次发作心血管事件的年龄、服用激素累积时间及冠脉造影结果进行回顾性分析.结果 共纳入观察组12例,对照组124例.与对照组比较,观察组患者首次发作ACS时传统危险因素较少[(1.21±0.97)个/例 vs (2.48±1.29)个/例,P<0.01]、年龄较小[(45.0±12.8)岁 vs (57.0±16.4)岁,P<0.01].观察组患者冠脉造影可见血管闭塞、狭窄、瘤样扩张和急性血栓形成,其中5例发生血管闭塞(限左主干、前降支、回旋支、右冠状动脉),且均有冠脉内血栓形成,其血管闭塞发生率高于单纯ACS患者[41.67%(5/12) vs 23.39%(29/124)],差异有统计学意义(P<0.05).结论 SLE合并ACS患者首次发作ACS时传统冠心病危险因素较少,年龄较小,但冠状动脉闭塞率较高,且多伴有冠状动脉内血栓形成. |
| 关键词: 系统性红斑狼疮 急性冠脉综合征 冠状动脉造影术 危险因素 |
| DOI：10.3724/SP.J.1008.2015.00087 |
| 投稿时间：2014-06-25修订日期：2014-11-20 |
| 基金项目: |
|
| Systemic lupus erythematosus combined with acute coronary syndrome: a clinical analysis |
| NA Jian1△,ZHU Yu-feng1△,CHEN Liang1△,WANG Gui-ming2,BAI Yuan1,QIN Yong-wen1* |
(1. Department of Cardiovasology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
2. Department of Pathology, The Second People's Hospital of Guangdong, Guangzhou 510317, Guangdong, China
△Co-first authors.
*Corresponding author) |
| Abstract: |
| Objective To investigate the clinical features and the characteristics of coronary artery lesions of systemic lupus erythematosus (SLE) patients complicated with acute coronary syndrome (ACS), so as to discuss the pathogenesis and clinical characteristics of these patients. Methods We retrospectively reviewed the clinical data of all the in-patients diagnosed with SLE in Changhai Hospital from May 2009 to May 2013, and those combined with ACS as confirmed by coronary angiography (CAG) were taken as the observing group; CAG-confirmed ACS patients at their fist onset without connective tissue disease during Jan. 2013 to May 2013 were taken as controls. The traditional risk factors of coronary heart diseases, age of first occurrence of cardiovascular event, cumulative time of corticosteroid therapy and CAG results were retrospectively analyzed and compared between the two groups. Results Twelve patients were finally enrolled in the observing group and 124 cases in the control group. Compared to the control group, SLE patients had significantly less traditional risk factors ([1.21±0.97] factor per case vs [2.48±1.29] factor per case, P<0.01) and were at a younger age ([45.0±12.8] years vs [57.0±16.4] years,P<0.01) at the first ACS event. CAG showed vascular occlusion, stenosis, aneurysm and acute thrombosis in SLE patients with ACS, with 5 patients having occluded blood vessels (restricted to the left main, left anterior descending artery, circumflex artery and right coronary artery) and all having intracoronary thrombosis. The incidence rate of occluded blood vessels was significantly higher in the observing group compared with that in the control group (41.67% [5/12]) vs 23.39% [29/124], P<0.05). Conclusion SLE patients combined with ACS have less traditional coronary artery disease risks at the first onset of ACS, but at a younger age, with higher incidence of coronary artery occlusion, mostly having intracoronary thrombosis. |
| Key words: systemic lupus erythematosus acute coronary syndrome coronary angiography risk factors |
