To investigate the risk factors of pulmonary arterial hypertension (PAH) in patients with systemic lupus erythematosus (SLE), and provide evidence for clinical diagnosis and treatment.

 English databases such as pubmed, the Cochrane library, embase and Chinese databases such as China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP database were searched by computer from the establishment of the database to December 25, 2023. Case-control studies on the risk factors of PAH in patients with SLE at home and abroad were selected, and the literature that met the evaluation criteria was screened. Two researchers independently conducted literature screening and literature information extraction, including the first author, publication time, sample size, research factors, etc. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the studies. stata15.0 software was used to analyze the data. The relationship between clinical manifestations and laboratory parameters and PAH in SLE patients was evaluated according to the risk ratio (RR) and 95% CI.

A total of 13 articles were included, including 8 case-control studies, 3 cohort studies, and 2 cross-sectional studies, NOS ≥6, and the overall quality of the articles was high. The risk of PAH in SLE patients with Raynaud's phenomenon was higher than that in SLE patients without Raynaud's phenomenon [OR = 2.54, 95%CI (1.95, 3.31), P < 0.05]. The risk of PAH in anti-U1-RNP positive SLE patients was higher than that in anti-U1-RNP negative SLE patients [OR = 1.93, 95%CI (1.07, 3.47), P < 0.05]. The risk of PAH in SLE patients with interstitial lung disease was higher than that in SLE patients without interstitial lung disease [OR = 3.60, 95%CI (2.11, 6.12), P < 0.05]. The risk of PAH in SLE patients with serositis was higher than that in SLE patients without serositis [OR = 2.96, 95%CI (1.98, 4.41), P < 0.05]. The risk of PAH in SLE patients with pericardial effusion was higher than that in SLE patients without pericardial effusion [OR = 3.13, 95%CI (2.23, 4.39), P < 0.05].

Raynaud's phenomenon, anti-U1-RNP antibody, interstitial lung disease, serositis and pericardial effusion are the risk factors of PAH in SLE patients, which may provide early warning for the diagnosis of PAH in SLE patients.