类风湿性关节炎患者心功能的超声心动图研究  

Assessment of the cardiac function in patients with rheumatoid arthritis by echocardiography

作　　者：齐亚军[1] 刘健[2] 曹云祥 孙玥[1] 王芳[1] 刘轶菲[1] 

机构地区：[1]安徽中医药大学研究生部,合肥市230038 [2]安徽中医药大学第一附属医院风湿免疫科

出　　处：《临床超声医学杂志》2013年第12期813-816,共4页Journal of Clinical Ultrasound in Medicine

基　　金：国家中医药重点学科中医痹病学建设项目[国中医药发(2009)30号];安徽省科技厅科研计划项目(11010402170);安徽中医内科应用基础与开发研究省级实验室项目[科条(2008)150号];安徽中医药大学科技创新团队项目(2010TD005)

摘　　要：目的研究类风湿关节炎(RA)患者心功能变化及其与其他临床指标的相关性。方法使用超声心动图检测300例RA患者(RA组)心功能变化,并与150例健康对照组进行比较;观察RA患者病珵、血压、心率、实验室指标与心功能参数相关性情况。结果 RA组心功能变化异常率为84.33%,明显高于对照组(36.67%),差异有统计学意义(P<0.01);与对照组比较,RA组舒张早期峰值血流速度(E峰)、左室短轴缩短率及舒张早、晚期峰值血流速度比值(E/A)降低,左房舒张期内径及舒张晚期峰值血流速度(A峰)升高,两组比较差异均有统计学意义(均P<0.01)。RA组心功能参数E峰与免疫球蛋白IgG及A峰与舒张压呈显著正相关(均P<0.01);E峰与a-酸性糖蛋白、超敏C-反应蛋白,E/A与收缩压及射血分数与类风湿因子均呈显著负相关(均P<0.05)。结论超声心动图是检测RA患者心功能的理想技术,定期运用超声心动图技术有利于早期发现RA患者心功能损害,对RA后期的诊断和治疗具有重要的指导意义。Objective To study the cardiac function changes of patients with rheumatoid arthritis （RA） and the correlation with other indicators. Methods Echocardiography was applied to observe the changes of cardiac function in 300 patients with RA, the results were compared with those in normal control（NC ） group; the correlation between cardiac function and course of disease, blood pressure, heart rate and laboratory indicators was analyzed. Results In RA group, the abnormal rate of cardiac function changes was 84.33%, which was significantly higher than that in NC group（P〈0.01 ）. In RA group, the early diastolic peak velocity（E）,left ventricular fractional shortening（FS）, the ratio of early diastolic peak velocity and late diastolic peak velocity （E/A） were decreased （all P〈0.01 ）. Left atrial diastolic diameter （LADd） and late diastolic peak velocity （A） were increased（ all P〈0.01 ）. Spearman correlation analysis showed： in RA patients, E peak and IgG, A peak and diastolic blood pressure, showed significant positive correlation（all P〈0.01 ）. E peak and a-acid glycoprotein, C-reactive protein, E/A and systolic blood pressure, ejection fraction and rheumatoid factor were significantly negatively correlated （all P〈0.05）. Conclusion Echocardiography is an ideal technology to assess the cardiac function of RA patients. Using the technology regularly is helpful for early detection of cardiac function damage of RA patients and meanwhile it has an important guiding significance to the diaguosis and therapy of RA.

关 键 词：超声心动描记术 类风湿关节炎 心功能 相关性分析 

分 类 号：R593.22[医药卫生—内科学] R540.45[医药卫生—临床医学]