左心室压力-应变环评价类风湿性关节炎患者左心室功能  

Evaluation of left ventricular function in patients with rheumatoid arthritis by noninvasive pressure-strain loop

作　　者：肖武平 张小杉[1] 王雅皙[1] 施依璐[1] 段莎莎[1] 赵捷 赵海玥 赵敏[1] Xiao Wuping;Zhang Xiaoshan;Wang Yaxi;Shi Yilu;Duan Shasha;Zhao Jie;Zhao Haiyue;Zhao Min(Department of Ultrasound,the Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院超声医学科,呼和浩特010050

出　　处：《中华超声影像学杂志》2022年第2期108-114,共7页Chinese Journal of Ultrasonography

基　　金：内蒙古自治区科学技术厅项目(2019GG081);内蒙古自治区自然科学基金面上项目(2019MS08148, 2021MS08018, 2016MS(LH)0808);内蒙古医科大学科技百万工程项目(YKD2020KJBW(LH)018);中央引导地方科技发展资金项目(2021ZY0026);内蒙古医科大学致远人才计划项目(ZY0110020);内蒙古自治区高等学校科学研究项目(NJZY21588)。

摘　　要：目的应用左室压力-应变环(PSL)评价类风湿性关节炎(RA)患者左心室心肌做功的应用价值。方法选取2020年4月至2021年6月于内蒙古医科大学附属医院就诊的RA患者75例(病例组)和健康体检者35例(对照组), 根据28关节疾病活动度评分(DAS28评分)分为低疾病活动度组(16例)、中疾病活动度组(35例)及高疾病活动度组(24例)。对所有受检者进行超声心动图检查, 采集常规超声数据并使用左室PSL技术分析得出心肌做功参数, 包括整体做功指数(GWI)、整体有用功(GCW)、整体无用功(GWW)、整体做功效率(GWE), 并计算心肌做功指数(MWI)、有用功(CW)、无用功(WW)、做功效率(WE)。比较病例组与对照组心肌做功参数的差异, 并对心肌做功参数与左室整体纵向应变(LVGLS)、左室射血分数(LVEF)、DAS28评分进行相关性分析。结果①各病例组与对照组临床资料差异无统计学意义(均P>0.05)。②中、高疾病活动度组LVGLS较对照组、低疾病活动度组显著减低(均P<0.05)。③中、高疾病活动度组GWI、GCW较对照组显著减低(均P<0.05), 各病例组GWW、GWE与对照组相比差异无统计学意义(均P>0.05);中、高疾病活动度组中间段MWI、心尖段MWI和CW, 以及中疾病活动度组中间段CW较对照组减低(均P<0.05)。④病例组GWI、GCW与LVEF呈显著正相关(rs1=0.253, P=0.008;rs2=0.261, P=0.024), 与LVGLS呈显著负相关(rs1=-0.525, P<0.001;rs2=-0.455, P<0.001), 各心肌做功参数与DAS28评分无显著相关(均P>0.05)。结论 PSL能早期反映中、高疾病活动度RA患者心功能受损情况, 可为临床评估患者心功能提供一种新的影像学方法。Objective To evaluate the application value of left ventricular pressure-strain loop(PSL)in patients with rheumatoid arthritis(RA)by the PSL.Methods From April 2020 to June 2021,75 RA patients(case group)and 35 healthy physical examination person(control group)were selected from the Affiliated Hospital of Inner Mongolia Medical University.According to the disease activity scores 28(DAS28)joint disease range of activity score,the patients were divided into low range of activity group(16 cases),medium range of activity group(35 cases)and high range of activity group(24 cases).Echocardiographic examinations were performed on all patients,conventional ultrasound data were collected and the left ventricular PSL technology was used to analyze the myocardial work parameters,including global work index(GWI),global constructive work(GCW),global waste work(GWW)and global work efficiency(GWE).The mean values of myocardial work index(MWI),constructive work(CW),waste work(WW)and work efficiency(WE)were calculated.The differences of myocardial work parameters between the case groups and the control group were compared,and the correlation analysis of myocardial work parameters with global longitudinal strain of left ventricle(LVGLS),left ventricular ejection fraction(LVEF)and DAS28 scores were conducted.Results①There were no statistically significant differences of clinical data between each case group and the control group(all P>0.05).②Compared with the control group and low disease activity group,the LVGLS of medium and high disease activity groups decreased obviously(all P<0.05).③The GWI and GCW of the medium and high disease activity groups were significantly lower than those of the control group(all P<0.05),and there were no statistically significant differences of GWW and GWE between the case groups and the control group(all P>0.05).The mid-segment MWI,apical MWI and CW of the medium and high disease activity case groups,and the mid-segment CW of the medium disease activity case group were lower than those of the co

关 键 词：超声心动描记术 类风湿性关节炎 左室压力-应变环 心肌做功 心室功能 左 

分 类 号：R593.22[医药卫生—内科学]