摘要
目的分析系统性红斑狼疮(SLE)患者并发血栓/栓塞的情况,以探讨SLE患者易发血栓的相关因素。方法回顾性分析了近6年北京协和医院收治的1091例SLE患者并发血栓/栓塞的情况,以及当时SLE活动情况(SLE疾病活动指数,SLEDAI)、抗磷脂抗体(APA)、抗内皮细胞抗体(AECA)、低蛋白血症、高球蛋白血症等因素。血栓/栓塞的诊断主要依靠同位素肺通气/灌注(V/Q)显像、CT、核磁共振(MRI)、血管彩超、核磁共振血管显像(MBA)、血管造影及病理学等检查方法。结果 1091例SLE患者中59例(5.4％)并发血栓/栓塞;死亡5例,占并发血栓/栓塞者的8.5％。血栓/栓塞最常累及的器官包括下肢深静脉(34.4％)、中枢神经系统(29.5％)和肺(21.3％)。并发血栓/栓塞的患者其SLE疾病活动度明显高于无血栓/栓塞者(SLEDAI:16.6±7.02 vs 9.7±5.9分,t检验,P<0.05);同时,并发血栓/栓塞者抗磷脂抗体(APA)阳性率明显高于对照组(54.2％vs 29.5％,卡方检验,P<0.001)。胆固醇(TC)增高和低密度脂蛋白(LDL)增高者在合并血栓/栓塞者中发生率明显高于无血栓/栓塞组(P<0.01)。结论 SLE并发血栓和/或栓塞是SLE患者的重要临床表现,为SLE死亡的主要原因之一。SLE疾病明显活动、APA阳性、胆固醇及LDL增高是血栓/栓塞的易患因素。
Objective To evaluate the thrombosis/embolism in patients with systemic lupus erythematosus (SLE) and analyze the risk factors associated with thrombosis.Methods A total of 1091 SLE patients,who admitted to PUMC hospital during the recent 6 years were collected.The patients with thrombosis and/or embolism were confirmed by imagine or Doppler studies or histopathologic studies.Disease activity of SLE recorded as SLE disease activity index (SLEDAI).Results 59 patients had thrombotic events,account for 5.4% of SLE patients.5 of the 59 patients dead,the mortality was 8.5%.The most involved organs with thrombotic events were lower extremities (34.4%),central nerve system (29.5%) and lung (21.3%).Disease activity in patients with thrombotic events was significantly higher than the patients without thrombotic events (SLEDAI:16.6±7.02 vs 9.7±5.9,t test P<0.05);anti-phospholipid antibodies (APA) was significantly higher in patients with thrombotic events (54.2% vs 29.5% controls,Chi square test,P<0.001);hypercholesterolemia and increased low density lipoprotein were more frequently found in patients with thrombotic events (P< 0.01).Conclusions Patients with SLE had high incidence of thrombosis/ embolism.The thrombotic events were primarily a cause of death in SLE patients.High disease activity,APA (+),hypercholesterolemia and increased low density lipoprotein could be risk factors in the development of thrombotic episodes.
出处
《医学研究通讯》
2004年第3期12-15,共4页
Bulletin of Medical Research
基金
首都医学发展科研基金(首都ZD199801)
