斑点追踪成像技术评价类风湿关节炎患者左室收缩功能的Meta分析  

Assessment of left ventricular systolic function in patients with rheumatoid arthritis by speckle tracking imaging:a Meta analysis

作　　者：唐立[1] 胡劼[1] 孙运峰[1] 唐莎 周玉成 李云[1] 魏阳 李华[1] TANG Li;HU Jie;SUN Yunfeng;TANG Sha;ZHOU Yucheng;LI Yun;WEI Yang;LI Hua(Department of Echocardiography,the Affiliated TCM Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学附属中医医院心脏超声科,乌鲁木齐市830000

出　　处：《临床超声医学杂志》2018年第10期665-670,共6页Journal of Clinical Ultrasound in Medicine

基　　金：新疆维吾尔自治区自然科学基金面上项目(2015211C147)

摘　　要：目的评价斑点追踪成像(STI)技术对类风湿关节炎(RA)患者左室收缩功能的诊断价值。方法计算机检索PubMed、Ovid、The Cochrane Library、CNKI、万方及维普等数据库,搜索国内外有关二维STI或实时三维STI评价RA患者左室收缩功能的对照研究。检索时间均从建库至2017年5月13日。经筛选文献、提取资料并评价纳入研究的偏倚风险后,应用RevMan 5.3软件进行Meta分析,计算权重均数差(WMD)和95%可信区间。结果最终纳入9项临床研究,共计610例RA患者(RA组)和361例健康对照者(对照组)。RA组较对照组左室射血分数降低,差异有统计学意义[WMD=-0.99(-1.47^-0.52),P<0.01]。左室整体应变中径向应变同质性较好,RA组左室整体径向应变小于对照组,差异有统计学意义[WMD=-2.24(-2.84^-1.64),P<0.01];整体纵向应变异质性较大(I2=80%,P<0.001),可能来源于纳入文献的研究质量;整体环向应变和整体面积应变异质性较大(I2=87%、90%,均P<0.001),异质性来源不明。结论 STI技术在评价RA患者左室收缩功能方面具有一定的临床价值。Objective To evaluate the diagnostic value of two-or three-dimensional speckle tracking imaging（2D-STI or 3D-STI） for left ventricular systolic function in rheumatoid arthritis（RA） patients.Methods Electronic databases including PubMed, Ovid, Cochrane Library, CNKI ,VIP,WanFang were searched for published clinical studies about left ventricular systolic function assessed by 2D-STI or 3D-STI in RA patients.Search time was from inception to May 13, 2017.Meta -analysis was performed using RevMan 5.3 software after screening the researches,extracting the data and assessing the risk of bias.Weighted mean difference（WMD） and 95% confidence interval were calculated.Results Nine studies were included with total of 610 RA patients（RA group） and 361 healthy control participants（control group）.Meta analysis revealed that left ventricular rejection fraction （ LVEF） of RA group was lower than that of control group E W MD = - 0.99 （ - 1.47- -0.52 ）, P〈 0.01 ].The left ventricular systolic function GRS of RA group was lower than that of control groupEWMD=-2.24（-2.84-1.64）, P〈0.01 ] with good homogeneity as well.There were the heterogeneity of GLS （ I^2=80%, P〈0.001 ）, GCS （ I^2=87%, P〈0.001 ） and GAS （ F=90%, P〈0.001 ） about the 9 studie.Conclusion 2D- or 3D-STI has a certain clinical value in evaluation of left ventricular function in RA patients.

关 键 词：斑点追踪成像 类风湿关节炎 应变 心肌 左室 META分析 

分 类 号：R540.45[医药卫生—心血管疾病] R593[医药卫生—内科学]