系统性红斑狼疮患者冠状动脉钙化情况的临床评估和研究

摘要

Objective To study the frequency and extent of coronary artery calcification in SLE patients and to identify the associated risk factors.MethodsForty-five SLE patients and 45 matched healthy controls were included in the study. Patients and controls were subjected to full history taking, clinical examination, laboratory investigations Multi detector CT study of the coronaries was performed.Results The homocysteine and Triglycerides level was significantly higher in the patients(P<0.05). Coronary calcification was detected in 10(22.2%) of the patients and none of the control. The median calcium score was 69 (27-538) in the patients. Patients with calcification had significantly higher cholesterol, triglycerides and homocysteine levels. The calcium score significantly correlated with the serum cholesterol (r=0.563,P<0.05) and homocysteine level (r=0.71,P<0.05).Conclusion Compared with the general population coronary artery calcification is more common in SLE patients with a moderate extent which indicated Premature coronary artery atherosclerosis. Higher cholesterol and homocysteine are risk factor for coronary artery calcification in SLE.%目的：探讨系统性红斑狼疮（SLE）患者冠状动脉钙化的发生率和严重程度，并分析SLE患者出现冠状动脉钙化的相关危险因素。方法研究纳入45例SLE患者和45例健康对照。所有研究对象行常规临床和实验室生化检测。利用多层螺旋CT检测研究对象的冠状动脉钙化程度，以诊断及评估冠状动脉粥样硬化的发生。结果 SLE患者的甘油三酯和同型半胱氨酸水平均显著高于对照组（P＜0.05）。10例SLE患者存在冠状动脉钙化（22.2%），钙化积分中位值为69（27~538），对照组未发现冠状动脉钙化。出现冠状动脉钙化的SLE患者总胆固醇水平、甘油三酯水平以及同型半胱氨酸水平均高于未出现动脉钙化的患者。SLE患者的钙化积分与总胆固醇水平以及同型半胱氨酸水平呈正比（r=0.63和0.71，P＜0.05）。结论相对健康人群，SLE患者冠状动脉钙化发生率较高，但程度并不严重，提示早期动脉粥样硬化的存在，这可能与SLE患者较高的心血管事件发生率有关。较高的总胆固醇水平和同型半胱氨酸水平可能是SLE患者出现早期冠状动脉粥样硬化的危险因素。