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目的:观察长期服用羟氯喹对系统性红斑狼疮(SLE)患者血脂及心功能的影响。方法:选择确诊的SLE 84例,随机分为观察组和对照组各42例。对照组给予口服泼尼松治疗,观察组在泼尼松治疗基础上给予羟氯喹口服。比较两组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和脂蛋白a[Lp(a)]水平,以及心脏超声结果。结果:观察组治疗后12个月及24个月,TC、LDL-C与TG水平显著低于治疗前,HDL-C水平显著高于治疗前(P<0.05)。对照组治疗后24个月,LDL-C与TC水平均显著高于治疗前(P<0.05)。治疗后24个月,观察组TC、LDL-C与TG水平显著或非常显著低于对照组,HDL-C水平显著高于对照组(P<0.05,P<0.05)。观察组治疗后24个月,左心室舒张末期内径(LVEDD)显著降低,E/A显著增高(P<0.05);对照组治疗后24个月,LVEDD显著降低(P<0.05)。两组治疗后左心室结构及功能比较,均差异不显著(P>0.05)。结论:长期服用羟氯喹可改善SLE患者的血脂代谢紊乱,但对左心室结构以及功能的改善尚待继续观察。
Objective: To observe the effects of long-term use of hydroxychloroquine on blood lipid and cardiac function in patients with systemic lupus erythematosus (SLE). Methods: 84 cases of SLE were selected and randomly divided into observation group and control group, 42 cases each. The control group was treated with oral prednisone. The observation group was given oral hydroxychloroquine on the basis of prednisone treatment. The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and lipoprotein a [Lp (a) Echocardiographic results. Results: The levels of TC, LDL-C and TG in observation group at 12 and 24 months after treatment were significantly lower than those before treatment, and the levels of HDL-C were significantly higher than those before treatment (P <0.05). Control group 24 months after treatment, LDL-C and TC levels were significantly higher than before treatment (P <0.05). At 24 months after treatment, the levels of TC, LDL-C and TG in the observation group were significantly lower than those in the control group (P <0.05, P <0.05). At 24 months after treatment, the LVEDD and E / A in the observation group were significantly increased (P <0.05). LVEDD was significantly decreased in the control group at 24 months (P <0.05). The left ventricular structure and function of the two groups after treatment were not significantly different (P> 0.05). CONCLUSION: Long-term use of hydroxychloroquine can improve blood lipid metabolism disorder in patients with SLE, but the improvement of left ventricular structure and function remains to be observed.