发生率和与狼中复发性心周炎相关的因素
Yoo Jin Kim1, Jana Lovell2, Alaa Diab2
1Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
JAMA network open
|February 25, 2025
概括
在全身性红性狼 (SLE) 中,复发性心膜炎很常见,特别是在患有活跃疾病的年轻患者中. 口服普得尼松使用增加了复发风险,这表明在患有心周炎的SLE患者中,应谨慎使用皮质类固醇.
科学领域:
- 心脏病学 心脏病学
- 类风湿病学 类风湿病学
- 系统性红斑狼 (SLE) 研究研究
背景情况:
- 周心炎是SLE患者常见的心脏并发症.
- 心膜炎的复发在SLE中很常见,但患病率和危险因素仍然不清楚.
研究的目的:
- 为了确定SLE患者中复发性心膜炎的频率.
- 确定与SLE中心膜炎复发相关的风险因素.
主要方法:
- 从1988年到2023年对SLE患者进行的回顾性队列研究.
- 利用雌激素在全身性红斑狼中的安全性,对SLE疾病活动指数 (SELENA-SLEDAI) 的国家评估修订,以定义心膜炎.
- 在初始发作后至少6周评估复发.
主要成果:
- 在590名SLE患者中,有120名患者 (20.3%) 患有复发性心膜炎.
- 复发率为0.053人/年.
- 复发的危险因素包括年龄较小,普得尼松治疗 (≥20毫克),活跃的SLE (SLEDAI ≥3) 和最初发作以来的时间较短.
结论:
- 在SLE中,复发性心膜炎在第一年内更有可能发生.
- 年轻的患者,患有活跃疾病的患者和服用口服普雷尼松的患者的风险更高.
- 研究结果表明,在SLE患者中,口服皮质类固醇应谨慎使用,以治疗心膜炎.
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