Whole blood viscosity and arterial thrombotic events in patients with systemic lupus erythematosus
Whole blood viscosity and arterial thrombotic events in patients with systemic lupus erythematosus
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DOI：
10.1002/art.22766
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发表时间：
2007-06-15
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影响因子：
--
通讯作者：
Utset, Tammy O.
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文献类型：
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作者：
Booth, Stephanie;Chohan, Saima;Utset, Tammy O.
Objective.确定全身性红斑狼疮（SLE）患者，特别是有血栓形成或动脉粥样硬化血栓形成事件史的SLE患者的全血粘度（WBV）是否升高，WBV是一种流变学变量，可导致一般人群中心肌梗死和卒中的风险。由于狼疮患者动脉和静脉血栓形成的高发生率不能用传统的危险因素来解释，因此WBV升高可能是一个容易测量的非传统危险因素，以确定SLE患者血栓形成事件的高风险。60例SLE患者（30例有血栓形成事件史）和20例匹配的对照组被招募到研究中。血栓形成组进一步细分为动脉血栓形成组（n = 17）。WBV值在9种不同的剪切速率（1、2、5、10、50、100、150、300和1，000秒（-1））下测定。然后通过重复测量方差分析比较两组之间的WBV。与对照组（P = 0.022）或无动脉事件的SLE患者（P = 0.014）相比，有动脉事件史的SLE患者WBV显著升高。总SLE组的WBV与对照组无差异。WBV的差异在较低剪切速率（1、2、5、10、50和100秒（-1））下最为显著。抗凝、泼尼松剂量和抗磷脂抗体对WBV无显著影响。我们的研究表明，WBV是选择性升高的SLE患者动脉事件的历史。尽管这种相关性是显著的，但仍需要进行纵向研究来评估WBV对SLE动脉粥样硬化血栓形成事件的阳性预测价值。
Objective. To determine if whole blood viscosity (WBV), a rheologic variable contributing to risk of myocardial infarction and stroke in the general population, is elevated in patients with systemic lupus erythematosus (SLE), particularly SLE patients with a history of thrombotic or atherothrombotic events. Because the high rates of arterial and venous thrombosis in lupus cannot be explained by traditional risk factors, elevated WBV may be an easily measurable nontraditional risk factor to identify SLE patients at high risk for thrombotic events.Methods. Sixty SLE patients (30 with a history of a thrombotic event) and 20 matched controls were recruited into the study. The thrombosis group was further subdivided into an arterial thrombosis group (n = 17). WBV values were determined at 9 different shear rates (1, 2, 5, 10, 50, 100, 150, 300, and 1,000 seconds(-1)). WBV was then compared between groups by repeated-measures analysis of variance.Results. SLE patients with a history of arterial events had significantly elevated WBV relative to either controls (P = 0.022) or SLE patients without arterial events (P = 0.014). WBV in the total SLE group did not differ from controls. Differences in WBV were most prominent at lower shear rates (1, 2, 5, 10, 50, and 100 seconds(-1)). Anticoagulation, prednisone dose, and antiphospholipid antibodies did not significantly impact WBV.Conclusion. Our study demonstrated that WBV is selectively elevated in patients with SLE with a history of arterial events. Although this association is striking, longitudinal studies are needed to assess the positive predictive value of WBV for atherothrombotic events in SLE.