类风湿关节炎患者左室整体收缩功能的超声三维斑点追踪成像技术评价  

Assessment of left ventricular global systolic function in patients with rheumatoid arthritis by three-dimensional speckle tracking echocardiography

作　　者：张瑞芳[1] 段会参 郭海燕[1] 雷留彬[1] 孙璐璐[1] ZHANG Ruifang DUAN Huican GUO Haiyan LEI Liubin SUN Lulu(Department of Ultrasound, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 45005)

机构地区：[1]郑州大学第一附属医院超声科,郑州450052

出　　处：《郑州大学学报（医学版）》2016年第5期660-663,共4页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的:应用超声三维斑点追踪成像(3D-STI)技术分析类风湿关节炎(RA)患者左室心肌应变,评价其左室整体收缩功能。方法:选取RA患者30例(RA组)及年龄、性别相匹配的健康体检者30例(对照组),分别行经胸常规二维超声心动图获取左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)等指标;采集左室三维全容积动态图像并运用3D-STI分析软件进行分析,获得左室心肌整体纵向应变(GLS)、圆周应变(GCS)、径向应变(GRS)、面积应变(GAS);比较2组间上述指标的差异。结果:(1)与对照组比较,RA组GLS、GCS、GRS及GAS均减低,差异有统计学意义(P<0.05)。(2)GLS、GCS、GRS和GAS诊断RA患者左室收缩功能损伤的曲线下面积分别为0.83、0.74、0.67和0.86。(3)RA组左室GLS、GCS、GRS、GAS与病程有关(r=0.631、0.365、-0.325、0.680,P均<0.05)。结论:3D-STI能简便、准确评价RA患者左室整体收缩功能的早期变化。Aim： To investigate the diagnostic value of three-dimensional speckle tracking imaging（3D-STI）for estimating left ventricular global strains in patients with rheumatoid arthritis（RA）.Methods： A total of 30 cases of RA（RA group）and 30 gender,age matched healthy volunteers（control group）were enrolled in this study. Left ventricular ejection fraction（LVEF）, left ventricular end-diastolic volume（LVEDV）, left ventricular end-systolic volume（LVESV）and others two-dimensional data by transthoracic conventional echocardiography were obtained in all subjects.Left ventricular real time three-dimensional dynamic imaging were acquired. Then the left ventricular global longitudinal strain（GLS）, global circumferential strain（GCS）, global radial strain（GRS）and global area strain（GAS）were analyzed by 3D-STI off-line analysis software. These values were compared between the two groups.Results： Compared with controls, GLS, GCS, GRS and GAS were significantly reduced in patients with RA（P〈0.05）. The area under receiver operating characteristics curve of GLS, GCS, GRS and GAS to diagnose left ventricular systolic dysfunction of patients with RA were 0.83, 0.74, 0.67 and 0.86. GLS, GCS, GRS and GAS were correlated with course of disease（r=0.631,0.365,-0.325,0.680, P〈0.05）.Conclusion： 3D-STI could early detect the changes of left ventricular global systolic function for RA patients.

关 键 词：超声心动描记术 三维 类风湿关节炎 左室功能 斑点追踪成像 应变 

分 类 号：R445.1[医药卫生—影像医学与核医学]