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目的总结系统性红斑狼疮(SLE)患者合并冠心病的临床特点。方法对1970-2006年北京协和医院院诊断为 SLE 合并冠心病11例患者传统危险因素、第一次心脏事件发作时的情况、SLE 诊断、治疗及活动情况进行了回顾性分析。结果 SLE 患者发生冠心病的年龄较小为(53.9±8.1)岁;冠心病传统危险因素较少为(1.3±0.8)个/例;糖皮质激素使用前后各项血脂指标均有显著增高(P<0.05);发生心脏事件时的狼疮活动评分(SLEDAI)较高为(12.0±10.3)分;SLE患者冠状动脉(冠脉)病变程度较重,表现为弥漫狭窄、重度钙化。结论 SLE 患者早发冠心病不能完全用传统危险因素来解释,而且冠脉病变程度往往较重,预后差,需要尽早干预,尽量延缓疾病进程,并使用元创检查加强早期检出率,从而改善预后。
Objective To summarize the clinical features of patients with systemic lupus erythematosus (SLE) complicated with coronary heart disease. Methods The retrospective analysis of 11 traditional Chinese patients diagnosed as SLE with coronary heart disease from the Beijing Union Medical College Hospital from 1970 to 2006, the first risk of heart attack, the diagnosis, treatment and activity of SLE were retrospectively analyzed. Results The age of coronary heart disease in SLE patients was (53.9 ± 8.1) years old. The traditional risk factors of coronary heart disease were less (1.3 ± 0.8) / cases. The indexes of blood lipid in patients with SLE before and after glucocorticoid therapy were significantly increased (P <0.05). The lupus activity score (SLEDAI) at the time of cardiac event was (12.0 ± 10.3) points higher. The degree of coronary artery (coronary artery) lesion in SLE patients was severe, with diffuse stenosis and severe calcification. Conclusions The premature coronary heart disease in SLE patients can not be completely explained by traditional risk factors. The severity of coronary artery lesions is often severe and the prognosis is poor. Interventions should be made as early as possible to delay the progression of the disease and the early detection rate should be enhanced by using meta-invasive techniques to improve the detection rate Prognosis.