摘要
目的采用斑点追踪超声心动图定量技术可视化评估系统性红斑狼疮(SLE)患者左心室四维应变和扭转等心肌力学参数变化,揭示该类患者可能存在的亚临床左心室心肌功能损伤。方法选取2017年7月至2018年1月在四川省人民医院就诊的无心脏受累常规证据的SLE确诊患者59例(SLE组)和同期体检中心年龄、性别相匹配的健康志愿者37例(健康对照组),两组均行常规超声心动图(TTE)、超声组织多普勒成像(TDI)和四维超声自动左心室定量技术(4D Auto LVQ)检测,获取左心室几何构型相关参数:左心室后壁舒张末期厚度(LVPWT)、左心室舒张末期内径(LVEDD)、室间隔舒张末期厚度(IVST)、左心室舒张末期容积(EDV)、左心室收缩末期容积(ESV);左心室心功能相关参数:射血分数(EF)、每搏量(SV)、左心室心肌做功指数(MPI);左心室心肌收缩期整体纵向应变(GLS)、收缩期整体圆周应变(GCS)、收缩期整体径向应变(GRS)、收缩期整体面积应变(GAS)、旋转角度(twist)和扭转(torsion)。采用独立样本t检验比较两组相关参数测量值的差异。结果(1)左心室构型相关参数:SLE组LVPWT、IVST测值均在正常参考值范围内,但较健康对照组测值增大,差异均有统计学意义(t=5.816、5.366,P均<0.05);SLE组左心室心肌质量和质量指数均较健康对照组测值增加:[LVM:(122.3±30.8)g vs (95.8±22.3)g,LVMI:(82.3±17.6)g/m^2 vs(65.0±13.5)g/m^2,EDmass:(109.3±13.3)g vs(100.7±10.6)g,ESmass:(110.0±13.3)g vs(101.1±10.7)g],差异均有统计学意义(t=4.880、5.421、3.357、3.439,P均<0.05);两组LVEDD比较,差异无统计学意义(P> 0.05);(2)SLE组与健康对照组LVEF均>60%,两组LVEF、FS、SV差异均无统计学意义(P均> 0.05);TDI相关参数:SLE组MPI和平均E/e均较健康对照组测值增大:[MPI:0.47±0.10 vs 0.38±0.07,平均E/e:8.0±1.7 vs 6.9±0.9],差异均有统计学意义(t=4.352、4.009,P均<0.05);(3)SLE组GLS、GCS、GRS及GAS均显著低于健康对照
Objective To visualize and quantitatively evaluate the left ventricular four-dimensional strain and torsion parameters in patients with systemic lupus erythematosus(SLE) by speckle tracing echocardiography to reveal subclinical left ventricular myocardial dysfunction. Methods Fifty-nine patients suffering from SLE without evidence of myocardial impairment at Sichuan Provincial People’s Hospital from July 2017 to January 2018 were selected(SLE group), and 37 age and sex-matched healthy volunteers matched undergoing physical examination during the same period were selected as a healthy control group.All of the subjects underwent standard transthoracic echocardiography, 4 D Auto LVQ, and TDI examinations.The cumulative left ventricular geometry data, such as left ventricular posterior wall end-diastolic thickness(LVPWT), left ventricular end-diastolic diameter(LVEDD), ventricular septal end-diastolic thickness(IVST),left ventricular end-diastolic volume(EDV), and end-systolic volume(ESV);left ventricular functional data, such as left ventricular ejection fraction(LVEF), stroke volume(SV), and left ventricular myocardial performance index(MPI);mean E/e and left ventricular global longitudinal strain(GLS), left ventricular global circumferential strain(GCS), left ventricular global radial strain(GRS), left ventricular global area strain(GAS), twist, and torsion were measured. The above parameters between the two groups were compared for difference by the independent-samples t-test. Results For parameters related to left ventricular geometry, the values of LVPWT and IVST in the SLE group were within the normal reference range, but were significantly higher than those of the healthy control group(t=5.816、5.336, P < 0.05 for both). The values of myocardial mass and myocardial mass index were significantly higher in the SLE group than in the healthy control group:[LVM:(122.3±30.8) g vs(95.8±22.3) g, LVMI:(82.3±17.6) g/m^2 vs(65.0±13.5) g/m^2, EDmass:(109.3±13.3) g vs(100.7±10.6) g, ESmass:(110.0±13.3) g vs(101.
作者
罗玲
尹立雪
王斯佳
郭智宇
Luo Ling;Yin Lixue;Wang Sijia;Guo Zhiyu(Key Laboratory of Ultrasound in Cardiac Electrophysiology and Bio-mechanics of Sichuan Province, Institute of Ultrasound in Medicine, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China;North Sichuan Medical College, Nanchong 637000, China;GE Healthcare Ultrasound Clinical Education Team, Chengdu 600731, China)
出处
《中华医学超声杂志（电子版）》
CSCD
北大核心
2019年第2期108-114,共7页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
系统性红斑狼疮
四维超声
亚临床
心肌功能
Systemic lupus erythematosus
Four-dimensional echocardiography
Subclinical
Myocardial dysfunction
