中文摘要：

目的 研究系统性红斑狼疮（systemic lupus erythematosus,SLE）患者肺动脉压（pulmonary artery pressure,PAP）与肾功能损害程度的相关性,筛选预测肺动脉高压（pulmonary artery hypertension,PAH）的相关指标.方法 回顾性分析2007年12月-2009年12月温州医学院附属第一医院住院患者67例,男性4例,女性63例,根据有无PAH分为2组,诊断为SLE合并PAH的患者32例作为病例组,诊断为SLE而不合并PAH的患者35例为对照组,比较2组PAP和肾功能,并做PAH与肾功能的Pearson分析与ROC曲线分析.对各个研究因素采用逐步引入--剔除法,建立线性回归模型.结果 选取评价肾功能的常用指标血肌酐、血尿素氮、血尿酸及24h尿蛋白定量作为预测因素,其与PAP的关系分别是,血肌酐与PAP压呈线性关系（P＜0.01）,24h尿蛋白定量与PAP呈线性关系（P＜0.01）,血尿酸、血尿素氮与PAP不呈线性关系（P＞0.05）.将血肌酐、24h尿蛋白定量、血尿酸、血尿素氮纳入到线性回归模型分析,得到线性回归方程Y=21.460＋0.136X1＋1.422X2（Y代表肺动脉收缩压,X1代表血肌酐,X2代表24h尿蛋白定量）.结论 血肌酐和24h尿蛋白定量是SLE患者肾功能损害并发PAH的危险预测因素,一旦发现肾功能损害,要尽早进行心脏彩色多普勒检查,早期发现和早期治疗有利于病情控制和改善预后.

英文摘要：

Objective To study the correlation between pulmonary artery pressure （PAP） and the renal impairment in systemic lupus erytbematosus （SLE）, and to select the pulmonary artery hypertension（PAH） related predictive factors. Methods Sixty-seven patients with SLE from December 2007 to December 2009 in the First Affiliated Hospital of Wenzhou Medical College were analyzed retrospectively. The patients were divided into two groups, groupl ： SLE with PAH（ 32 cases）, group2 ： SLE without PAH （35 cases ）. Analysis was based on course of disease to compare the renal function and pulmonary artery pressure （PAP） between the two different groups. Renal function, serum creatinine （SCr） , blood urea nitrogen （BUN） , blood uric acid measured and compared between two groups. Then （BUA） and 24-hour urinary protein （24hPro） were Pearson analysis was performed between PAP and renal function. A case-control study was analyzed retrospectively among two groups. A linear regression model was selected as predictive factors. Results SCr, BUN, BUA and 24hPro were selected as predictive factors. PAP was linearly correlated to 24hPro （ P 〈 0.01 ） and SCr （ P 〈 0.01 ） in the patients with SLE. However, there were no linear relationship between PAP and BUA （ P 〉 0.05 ） and between PAP and BUN （P 〉 0. 05 ）. SCr,24hPro, BUA, and BUN were included into the linear regression model to analyze,then the relationship between the PAP with SCr and 24hPro was： Y = 21. 460 ＋ 0. 136X1 ＋ 1. 422X2 （ Y ： PAP ; X1 ： serum creatinine ; X2 ： 24-hour proteinuria）. Conclusion SCr and 24hPro were predictive factors for PAH in the patients with SLE. It is important to undergo Doppler echocardiography examination once renal damage is found to make diagnosis of PAH at the early stage.