Revista Brasileira de Ginecologia e Obstetrícia (Nov 2009)
Hiperperfusão no território orbital de gestantes portadoras de lúpus eritematoso sistêmico Orbital territory hyperperfusion in pregnant women with systemic lupus erythematosus
Abstract
OBJETIVO: analisar o comportamento da artéria oftálmica em grávidas portadoras de lúpus eritematoso sistêmico (GL), sem doença renal em atividade, comparando com não-grávidas com lúpus (NGL), sem doença renal em atividade e grávidas normais (GN). MÉTODOS: estudo observacional que analisou as variáveis doplervelocimétricas da artéria oftálmica de 20 GN, 10 GL e 17 NGL. As variáveis analisadas foram os índices de pulsatilidade (IP), a velocidade diastólica final (VDF) e a razão entre picos de velocidade (RPV). Foram calculadas as médias dos índices e respectivos desvios padrões. Para comparação das médias dos índices dos três grupos, utilizou-se o teste de variância (ANOVA) e prova pós-análise de Tukey, com intervalo de confiança de 95% (pPURPOSE: to analyze the ophthalmic artery functioning in pregnant women with systemic lupus erythematosus (PL) without active renal disease as compared to non-pregnant women with lupus (NPL) without active renal disease, and to normal pregnant women (PN). METHODS: observational study that analyzed ophthalmic artery dopplervelocimetric variables of 20 PN, 10 PL and 17 NPL women. The variables analyzed were: pulsatility index (PI), final diastolic velocity (FDV) and velocity peak ratio (VPR). Mean and standard deviation of these indexes were calculated. For group mean comparison, analysis of variance (ANOVA) and the post-hoc Tukey test have been used, with confidence interval of 95% (p<0.05). RESULTS: the PN group showed the following means and standard deviations of ophthalmic artery parameters: PI=2,4±0,3; VPR=0,5±0,1 e FDV=5,1±2,1 cm/s. The PL and NPL groups showed the following values, respectively: PI=2,0±0,4 and 1,9±0,4; VPR=0,6±0,1 and 0,6±0,1; FDV=9,7±3,9 cm/s and 8,1±4,3 cm/s. There was not significant mean difference between the PL and NPL groups for PI, VPR or FDV. However, statistically significant mean differences were observed between PN and PL for PI, VPR and FDV, with higher values of FDV and VPR in the PL group. CONCLUSIONS: there was a reduction of ophthalmic artery vascular impedance with orbital hyperfusion in the two groups of women with lupus erythematosus as compared to normal pregnant women. These results may help to improve the understanding on pathophysiology of systemic lupus erythematosus. In addition, the present method may be applied in future studies as a complementary procedure for the differential diagnosis between pre-eclampsia and renal failure due to lupus.
Keywords
