超声三维斑点追踪成像评价系统性红斑狼疮左心室整体收缩功能  

Three-dimensional speckle tracking imaging evaluation of left ventricular global systolic function in patients with systemic lupus erythematosus

作　　者：张瑞芳[1] 刘海艳[1] 赵丽娟[1] 段会参 杨灵霄[1] 张秀婷[1] 

机构地区：[1]郑州大学第一附属医院超声科,河南郑州450052

出　　处：《中国医学影像技术》2016年第2期254-257,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨三维斑点追踪成像(3D-STI)对系统性红斑狼疮(SLE)左心室整体收缩功能变化的诊断价值。方法分别对30例SLE患者(SLE组)及30名健康志愿者(对照组)行二维超声心动图和3D-STI检查。二维超声心动图测量左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、每搏输出量(SV)、舒张早期二尖瓣跨瓣血流速度(E)和舒张晚期二尖瓣跨瓣血流速度(A)。应用3D-STI行心肌运动分析,测量左心室整体纵向、圆周、径向及面积收缩期峰值应变(GLS、GCS、GRS、GAS)。对两组上述参数进行统计学分析。结果 SLE组二维超声心动图的测量数值(LVEDD、LVESD、LVEF、SV、E、A)与对照组比较,差异均无统计学意义(P均>0.05)。SLE组左心室GLS、GCS、GRS、GAS均较对照组减低,差异均有统计学意义(P均<0.05)。GLS诊断SLE的敏感度及特异度分别为93.3%、96.7%,GAS分别为90.0%、83.3%,高于GCS(80.0%、86.7%)和GRS(73.3%、76.7%)。结论 3D-STI可早期检测SLE左心室收缩功能异常。Objective To investigate clinical value of three-dimensional speckle tracking imaging （3D-STI） in diagnosing the left ventricular global systolic function of systemic lupus erythematosus （SLE） patients. Methods Thirty SLE patients （SLE group） and thirty gender-age-matched health subjects （control group） were underwent real-time 2D-echocardiography and 3D-STI. Left ventricular eject fraction （LVEF）, left ventricular end-diastolic diameter （LVEDD）, left ventricular end- systolic diameter （LVESD）, stroke volume （SV）, early diastolic mitral valve acrossthe flap of blood flow velocity （E） and late diastolic mitral valve blood flow velocity across the disc （A） were measured using two-dimensional echocardiography. The global peak ventricular systolic longitudinal strain （GLS）, global peak ventricular systolic circumferential strain （GCS）, global peak ventricular systolic radial strain （GRS）, global peak ventricular systolic area strain （GAS） were ana- lyzed using 3D-STI. Those parameters of two groups were statistically compared. Results Compared with control group, the difference of 2D-echocardiography measured value （LVEDD, LVESD, LVEF, SV, E, A） in SLE group was not statistically significant （all P〉0.05）, GLS, GCS, GRS, GAS of SLE group significantly decreased （all P〈0.05）. The sensitivity and specificity of GLS （93.3%, 96.7%） and GAS （90.0%, 83.3%） in the diagnosis of SLE were higher than those of GCS （80.0%, 86.7%） and GRS （73.3%, 76.7%）. Conclusion 3D-STI can early detect left ventricular systolic dysfunction of SLE patients.

关 键 词：系统性红斑狼疮 心室功能 左 超声心动描记术 三维 应变 

分 类 号：R593.24[医药卫生—内科学] R544.1[医药卫生—临床医学]