四维右室容积定量分析技术评估系统性红斑狼疮合并肺动脉高压患者右心功能  

Evaluation of right cardiac function in patients with systemic lupus erythematosus complicated with pulmonary arterial hypertension by four-dimensional right ventricular volume quantitative analysis technology

作　　者：张维[1] 肖芳[1] 唐敏 曹新丽 王晓磊[2] 王开振[2] ZHANG Wei;XIAO Fang;TANG Min;CAO Xinli;WANG Xiaolei;WANG Kaizhen(Department of Ultrasound,Chongqing Hospital of Traditional Chinese Medicine,Chongqing 400020,China)

机构地区：[1]重庆市中医院超声科,400020 [2]重庆市中医院肾病风湿科,400020

出　　处：《临床超声医学杂志》2022年第9期657-660,共4页Journal of Clinical Ultrasound in Medicine

基　　金：重庆市科卫联合中医药技术创新与应用发展项目(2021ZY023874)。

摘　　要：目的探讨四维右室容积定量分析(4D-RV-volume)技术评估系统性红斑狼疮(SLE)合并肺动脉高压(PAH)患者右心功能的临床应用价值。方法回顾性分析我院收治的198例SLE患者临床资料,依据其是否合并PAH分为合并PAH者102例(A组)、未合并PAH者96例(B组),另选同期我院健康体检者100例为对照组。应用4D-RV-volume技术检测各组右心功能指标,包括右室舒张末期面积(RVEDA)、右室心肌功能指数(RVMPI)、右室面积变化分数(RVFAC)、三尖瓣环收缩期位移(TAPSE)、肺动脉收缩压(PASP)、三尖瓣口舒张早期与晚期峰值流速的比值(E/A)、三尖瓣口舒张早期峰值流速与三尖瓣环舒张早期运动速度的比值(E/e’);采用系统性红斑狼疮活动度评分(SLEDAI)对患者病情进行评估,比较各组右心功能指标和SLEDAI评分的差异。应用Pearson相关分析法分析右心功能指标与SLEDAI评分的关系。结果①各组右心功能指标比较差异均有统计学意义(均P<0.001),A组RVEDA、RVMPI、PASP、E/e’均高于B组和对照组,RVFAC、TAPSE、E/A均低于B组和对照组,B组RVMPI、PASP、E/e’均高于对照组,差异均有统计学意义(均P<0.05);②各组SLEDAI评分比较差异有统计学意义(P<0.05),A组SLEDAI评分高于B组和对照组,B组SLEDAI评分高于对照组,差异均有统计学意义(均P<0.05);③Pearson相关分析显示,SLEDAI评分与RVEDA、RVMPI、PASP、E/e’均呈正相关(r=0.470、0.593、0.580、0.620,均P<0.001),与RVFAC、TAPSE、E/A均呈负相关(r=-0.728、-0.658、-0.411,均P<0.001)。结论4D-RV-volume技术能够有效评估SLE合并PAH患者右心功能的变化,具有较好的临床应用价值。Objective To explore the clinical application value of the four-dimensional right ventricular volume quantitative analysis(4D-RV-volume)technology in the evaluation of right cardiac function in patients with systemic lupus erythematosus(SLE)complicated with pulmonary arterial hypertension(PAH).Methods The clinical data of 198 SLE patients admitted to our hospital were retrospectively analyzed,among them 102 cases with PAH were groups A and 96 cases without PAH were group B,and another 100 healthy subjects during the same period were selected as the control group.Right cardiac function indicators including right ventricular end-diastolic area(RVEDA),right ventricular myocardial performance index(RVMPI),right ventricular fractional area change(RVFAC),tricuspid annular plane systolic excursion(TAPSE),pulmonary arterial systolic pressure(PASP),the ratio of early and late diastolic peak velocity of tricuspid valve orifice(E/A),the ratio of the tricuspid valve early diastolic peak velocity and the tricuspid annular early diastolic tissue velocity(E/e’)of each group were detected by 4D-RV-volume technology.The systemic lupus erythematosus disease activity index(SLEDAI)was used to evaluate the patient’s condition,and the results were compared and analyzed.The relationship between the right ventricular function indicators and the SLEDAI score was evaluated by Pearson correlation analysis.Results There were significant differences of right ventricular function indicators among three groups(all P<0.001).The RVEDA,RVMPI,PASP and E/e’in group A were higher than those in group B and control group,while RVFAC,TAPSE and E/A in group A were lower than those in group B and control group,and RVMPI,PASP and E/e’in group B were higher than those in the control group,there were statistically significant differences(all P<0.05).②The SLEDAI score in group A was higher than that in group B and control group,the SLEDAI score in group B was higher than that in control group,there were statistically significant differences(all P<0

关 键 词：四维右室容积定量分析技术 系统性红斑狼疮 肺动脉高压 心功能 右 

分 类 号：R540.45[医药卫生—心血管疾病] R322.1[医药卫生—内科学]