关键词: 狼疮性肾炎, 射血分数减低心力衰竭

Abstract: Ｏｂｊｅｃｔｉｖｅ：To investigate the clinical characteristics and prognosis of lupus nephritis(LN) complicated with heart failure and reduced ejection fraction (HFrEF).
Ｍｅｔｈｏｄｏｌｏｇｙ：LN patients admitted to the renal intensive care unit (ICU) of National Clinical Research Center of Kidney Diseases from January 2013 to February 2022 were enrolled in this study. According to the diagnostic criteria of HFrEF, we divided the patients into HFrEF group and control group. We compared the clinical feature and prognosis of the two groups, binary Logistic regression analysis on the risk factors in LN patients with HFrEF was performed.
Ｒｅｓｕｌｔｓ：A total of 46 LN patients met the diagnostic standard of HFrEF, accounting for 860％ of LN patients admitted to ICU during the same period. The HFrEF group patients had a longer course of lupus, more organs affected, higher NTproBNP, troponin, and left ventricular enddiastolic diameter(P<005). The HFrEF patients combined with higher property of lupus myocarditis, pulmonary arterial hypertension, valvular disease and chronic renal failure than the control group(P<005). Binary Logistic regression found that the course of lupus, chronic renal failure, history of lupus myocarditis, increased pulmonary artery pressure and diabetes mellitus were independent risk factors for HFrEF in LN patients. The 3month and 1year survival rates were 870％ and 739％ in HFrEF group, 921％ and 863％ in control group. The 3month and 1year renal survival rates were 674％ and 543％ in HFrEF group, 907％ and 842％ in control group. Univariate COX regression found that high SLEDAI, LVEF<30％ and valvular disease were risk factors for death in LN patients with HFrEF.
Ｃｏｎｃｌｕｓｉｏｎ：LN patients complicated with HFrEF were not rare, both person and renal survival rates were significantly decreased. Long course of lupus, history of lupus myocarditis, increased pulmonary arterial pressure, diabetes and chronic renal failure were high risk factors for HFrEF in LN, which should be paid much attention.

Key words: lupus nephritis, heart failure with reduced ejection fraction