全身性紅斑性狼瘡併發冠狀動脈心臟病－－病例報告

Coronary Artery Disease in Systemic Lupus Erythematosus-- Report of a Case

全身性紅斑性狼瘡病人常有心臟方面的異常，心包膜、心肌、心內膜甚至心臟表面的冠狀動脈都會發生問題。尤其是併發冠狀動脈心臟病，益增臨床病人在治療上的困難。其發生原因包括動脈硬化、血管栓塞及較罕見的血管炎。吾人報告一名20歲女性狼瘡病人由於胸痛而住院。心電圖、心肌氨酸及核醫掃描均顯示有冠狀動脈性心臟病。心導管檢查發現三條冠狀動脈均有廣泛性狹窄及硬化。實驗室及臨床檢查同時發現有狼瘡活性。此病人的冠狀動脈病變，相信與狼瘡活性引起的血管炎及長期服用類固醇造成的動脈硬化均有關連。

A 20-year-old female lupus patient was admitted with chest pain for 2 months. The electrocardiogram findings and elevated cardiac enzyme levels demonstrated myocardial ischemia. The coronary catheterization data shwoed diffuse coronary artery lesions with narrowing and calcification. Systemic lupus erythematosus displayed a variety of cardiac manifestations, and the presence of coronary artery disease increased the difficulty in clinical management.