摘要： 目的 回顾性分析系统性红斑狼疮（SLE）及抗磷脂抗体综合征（APS）伴Libman-Sacks心内膜炎的超声心动图表现及临床特征。方法 选择2016年1月至2020年12月于我院就诊经胸超声心动图（TTE）或经食管三维超声（3D-TEE）诊断为Libman-Sacks心内膜炎的23例SLE患者作为研究对象，对其超声表现及临床特征进行回顾性分析。根据是否合并APS进行分组，对比2组患者的超声及临床表现。结果 23例患者中，心内膜炎累及二尖瓣15例（65.2%），主动脉瓣5例（21.7%），三尖瓣1例（4.3%），同时累及二尖瓣及主动脉瓣2例（8.7%）。单纯SLE组14例，瓣膜中度及以上反流2例（14.3%）；合并APS组9例，其中合并脑血管栓塞3例（33.3%），瓣膜中度及以上反流4例（44.4%）。结论 TTE结合3D-TEE能够早期发现并精确显示赘生物的位置、大小及形态；合并APS的患者瓣膜病变程度更重，脑血管栓塞事件发生率更高。

Libman-Sacks心内膜炎的超声心动图表现及临床特征分析

梁彗莉, 王涛, 陈昕, 李潭, 杨军, 马春燕

中国医科大学附属第一医院心血管超声科, 沈阳 110001

收稿日期:2021-01-20出版日期:2021-06-30发布日期:2021-05-28
通讯作者:陈昕E-mail:chen_heart@163.com
作者简介:梁彗莉(1993-),女,医师,硕士.
基金资助:辽宁省自然科学基金（2020-BS-102）


关键词: Libman-Sacks心内膜炎, 系统性红斑狼疮, 抗磷脂抗体综合征, 超声心动图
Abstract: Objective To retrospectively analyze echocardiographic and clinical characteristics of patients with SLE and APS associated with Libman-Sacks endocarditis. Methods Twenty-three patients who were diagnosed with SLE associated with Libman-Sacks endocarditis by TTE or TEE in our hospital from January 2016 to December 2020 were enrolled. The echocardiographic manifestations and clinical features were retrospectively analyzed and summarized. The patients were divided into two groups according to APS,and the echocardiographic and clinical characteristics were compared. Results Among the 23 patients,the mitral valve was involved in 15 cases (65.2%),the aortic valve in 5 cases (21.7%),the tricuspid valve in 1 case (4.3%),and both mitral and aortic valves in 2 cases (8.7%). Fourteen cases were assigned to the SLE group,including 2 cases (14.3%) with moderate or severe valve regurgitation. Nine cases were assigned to the SLE-associated APS group,including 4 cases (44.4%) with moderate or severe regurgitation. Conclusion TTE combined with 3D-TEE is capable of displaying the location,size,and shape of vegetations early and accurately. Compared with the SLE group,more severe valve disease and a higher incidence of cerebrovascular embolism events are observed in the SLE-associated APS group.
Key words: Libman-Sacks endocarditis, systemic lupus erythematosus, antiphospholipid syndrome, echocardiography
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