左心室无创压力-应变环评估强直性脊柱炎患者左心室收缩功能  

Left ventricular pressure-strain loop for evaluation on left ventricular systolic function in patients with ankylosing spondylitis

作　　者：李思靓 袁建军 朱好辉 李帅[1] 郭雯[1] 张辉辉 孙硕文 徐雪艳 LI Siliang;YUAN Jianjun;ZHU Haohui;LI Shuai;GUO Wen;ZHANG Huihui;SUN Shuowen;XU Xueyan(Department of Ultrasound,Henan University People's Hospital,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南大学人民医院河南省人民医院超声科,河南郑州450003

出　　处：《中国医学影像技术》2021年第3期370-374,共5页Chinese Journal of Medical Imaging Technology

基　　金：河南省卫健委省部共建项目(SB201901093)。

摘　　要：目的探讨无创左心室压力-应变环(LV PSL)评估强直性脊柱炎(AS)患者左心室心肌收缩功能的价值。方法选取49例临床确诊AS患者和33名健康志愿者(对照组),根据C反应蛋白(CRP)水平将AS患者分为Ⅰ组(CRP<10 mg/L,n=25)、Ⅱ组(CRP≥10 mg/L,n=24)。比较3组常规超声心动图参数;根据二尖瓣、主动脉瓣开放及关闭时间构建无创LV PSL,获得左心室心肌做功参数,即整体纵向应变(GLS)、整体做功指数(GWI)、整体有效功(GCW)、整体无效功(GWW)及整体做功效率(GWE),并进行组间比较。结果3组常规超声心动图参数中仅二尖瓣前向舒张早期血流E峰(E)/二尖瓣环舒张早期峰值速度(e')差异有统计学意义,且Ⅰ组、Ⅱ组E/e'均大于对照组(P均<0.05),其余常规参数差异均无统计学意义(P均>0.05)。与对照组比较,Ⅰ、Ⅱ组GLS、GWI、GCW和GWE降低(P均<0.05),GWW增高(P<0.05);Ⅱ组GLS、GWI、GCW和GWE均低于Ⅰ组(P均<0.05)。结论LV PSL可早期定量评估AS患者左心室收缩功能。Objective To explore the value of the left ventricular pressure-strain loop(LV PSL)in evaluation on the left ventricular myocardial systolic function in patients with ankylosing spondylitis(AS).Methods Forty nine patients with AS and 33 healthy volunteers(control group)were selected.According to C reactive protein(CRP)level,AS patients were divided into groupⅠ(CRP<10 mg/L,n=25)and(CRP≥10 mg/L,n=24)groupⅡ.Conventional echocardiographic parameters were compared among 3 groups.LV PSL was constructed according to the opening and closing time of mitral valve and aortic valve,while the myocardial work parameters of left ventricle of global longitudinal strain(GLS),global work index(GWI),global effective work(GCW),global ineffective work(GWW)and global work efficiency(GWE)were obtained and compared among 3 groups.Results Among conventional echocardiographic parameters,only the E peak of mitral forward early diastole(E)/mitral annular early diastolic peak velocity(e')was significantly different among 3 groups,E/e'of groupⅠand groupⅡwere greater than that of control group(both P<0.05),and there was no significant difference of the other conventional parameters(all P>0.05).Compared with control group,GLS,GWI,GCW and GWE decreased and GWW increased in groupⅠandⅡ(all P<0.05),while GLS,GWI,GCW and GWE in groupⅡwere lower than those inⅠgroup(all P<0.05).Conclusion LV PSL could be used for early and quantitative assessment of left ventricular systolic function in patients with AS.

关 键 词：脊柱炎 强直性 心室功能 左 超声心动描记术 心肌做功 

分 类 号：R593.23[医药卫生—内科学] R540.45[医药卫生—临床医学]