全自动三维超声右心室定量软件评价系统性红斑狼疮患者右心室收缩功能  

Fully automated 3D ultrasound right ventricular quantitative software to evaluate right ventricular systolic function in patients with systemic lupus erythematosus

作　　者：代爽 冯艳红 DAI Shuang;FENG Yanhong(Department of Ultra-sound,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121001,China)

机构地区：[1]锦州医科大学附属第一医院超声科,辽宁锦州121001

出　　处：《实用医学杂志》2023年第5期636-641,共6页The Journal of Practical Medicine

基　　金：辽宁省自然科学基金项目(编号:20180530009)。

摘　　要：目的 应用全自动三维超声右心室定量软件(3DAutoRV)技术在系统性红斑狼疮(SLE)患者的右心室收缩功能评价中的应用价值。方法 选取2020年10月至2022年6月在锦州医科大学附属第一医院临床诊断为SLE患者,对入选的87例患者进行分组(A组:40例,三尖瓣反流峰值低速率≤2.8 m/s,无其他肺动脉高压超声心动图表现;B组:27例,三尖瓣反流峰值速率≤2.8 m/s,有其他肺动脉高压超声心动图表现或三尖瓣峰值速率2.9~3.4 m/s,无其他肺动脉高压超声心动图表现;C组:20例,三尖瓣反流峰值速率> 3.4 m/s),另选健康对照组29例(D组)。记录所有研究对象年龄、性别、心率、体质指数(BMI)、血压等,常规超声获得三尖瓣环收缩期峰值速度(S′)、右心室舒张末期横径(RVED)、右心室前壁厚度(RVAW)、三尖瓣环位移(TAPSE)、右心室面积变化率(RVFAC)。3DAutoRV软件获得三尖瓣环位移(TAPSE)、右心室面积变化率(RVFAC)、右心室舒张末期容积(RVEDV)、右心室收缩末期容积(RVESV)、右心室每搏量(RVSV)及右心室射血分数(RVEF)、右室基底段横径(RVD1)、右室中间段横径(RVD2)、右室长径(RVD3)、右心室游离壁纵向应变(FWLS)、右心室室间隔纵向应变(SLS)。结果 (1)对照组与SLE患者相比,年龄、收缩压、舒张压及BMI差异均无统计学意义(P> 0.05),而C组与其他组相比心率明显增快,差异有统计学意义(P <0.05)。(2)与D组相比,A组SLS、RVEF及FWLS减低,ESV增加。B组TAPSE、FAC、SLS、FWLS、RV EF、S′均减低,ESV、EDV增加(P <0.05)。C组TAPSE、FAC、SLS、FWLS、RV EF、S′均减低,ESV、EDV增加(P <0.05)。与A组相比,B组TAPSE、FAC、SLS、FWLS、RVEF减低,ESV、EDV增高(P <0.05),而S′差异无统计学意义(P> 0.05)。与B组相比,C组TAPSE、FAC、S′、SLS、FWLS、RVEF、RVSV减低,EDV、ESV均增加(P <0.05)。(3)FWLS预测SLE-PAH的最佳截断值为-23.32(AUC=0.90,P <0.001)。(4)一致性检验与重复性分析显示RVEF和FWLSObjective To application value of fully automatic three⁃dimensional ultrasound right ventricu⁃lar quantitative software(3DAutoRV)technology in the evaluation of right ventricular systolic function in patients with systemic lupus erythematosus(SLE).Methods The patients diagnosed with SLE in our hospital from October 2020 to June 2022 were selected.87 patients were divided into several groups,while 29 healthy people were re⁃cruited as a control group(group D).Age,sex,heart rate,body mass index(BMI),and blood pressure were re⁃corded in all the study subjects.Tricuspid annular displacement(TAPSE),tricuspid annular systolic velocity(S′),right ventricular area change rate(RVFAC),right ventricular end⁃diastolic transverse diameter(RVED),right ventricular anterior wall thickness(RVAW)were detected by routine ultrasound examination.3DAutoRV software obtained right ventricular end⁃diastolic volume(RVEDV),right ventricular end⁃systolic volume(RVESV),right ventricular stroke volume(RVSV),and right ventricular ejection fraction(RVEF),right ventricular basal seg⁃ment transverse diameter(RVD1),right ventricular median transverse diameter(RVD2),right ventricular length diameter(RVD3),right ventricular free wall longitudinal strain RVLS(SEP),and right ventricular septal longitudinal strain RVLS(SLS).Results As compared with SLE patients,there were no significant differences in age,systolic blood pressure,diastolic blood pressure and body mass index in the control group(P>0.05 for all compar⁃isons),while heart rate was significantly increased in the group with severe pulmonary hypertension as compared with other groups,and the difference was statistically significant(P<0.05 for all comparisons).As compared with the control group,SLE patients had a mild reduction in SLS、RVEF、FWLS and ESV increased.In the moderate likelihood group,TAPSE,FAC,SLS,FWLS,RVEF,and S′were all reduced,but ESV,EDV increased.TAPSE,FAC,SLS,FWLS,RVEF,and S′were reduced while ESV,EDV increased in the severe possible group.As compared

关 键 词：肺动脉高压 右心室功能 三维超声右心室定量 系统性红斑狼疮 

分 类 号：R593.24[医药卫生—内科学]