PSL技术在评估干燥综合征患者左室功能障碍中的应用  

Application of PSL technology in the assessment of left ventricular dysfunction in patients with Sjogren’s syndrome

作　　者：刘娟 程莲[2] 金晶 孙红光[2] LIU Juan;CHENG Lian;JIN Jing;SUN Hongguang(Department of Ultrasound,the Fourth People’s Hospital of Lianyungang,Lianyungang,Jiangsu 222000,China;Department of Ultrasound,Affiliated Hospital of Yangzhou University,Yangzhou,Jiangsu 225001,China)

机构地区：[1]江苏省连云港市第四人民医院超声科,222000 [2]扬州大学附属医院超声科,江苏扬州225001

出　　处：《重庆医学》2023年第15期2330-2334,共5页Chongqing medicine

基　　金：扬州市“十三五”科教强卫领军人才项目(LJRC201819)。

摘　　要：目的探讨压力应变环(PSL)技术在评估干燥综合征(SS)患者亚临床期左室收缩做功状况的应用,为早期发现心肌功能障碍提供依据。方法选择50例在扬州大学附属医院风湿免疫科诊断为原发性SS患者(SS组)和32名年龄、性别匹配的健康志愿者(对照组)纳入研究。用PSL技术获得整体做功指数(GWI)、整体有效功(GCW)、整体无效功(GWW)、整体做功效率(GWE)及峰值应变离散度(PSD),并进行组间比较。结果SS组的红细胞沉降率(ESR)、C反应蛋白(CRP)高于对照组;二尖瓣环位移(MAPSE)、二尖瓣左室舒张早期血流速度/二尖瓣环舒张早期运动速度(E/e’)低于对照组,差异有统计学意义(P<0.05);左心室整体纵向应变(GLS)、GWI、GCW、GWE低于对照组、GWW、PSD高于对照组,差异均有统计学意义(P<0.05)。GLS、GWI、GCW、GWE与病程、ESR、CPR呈负相关;GWW、PSD与病程、ESR、CPR呈正相关。重复性分析结果显示检查者内及检查者间可重复性良好。结论PSL技术是评估左心室收缩功能障碍及左室收缩不同步的敏感技术,可早于临床发现SS患者的左室收缩功能损伤。随着病程的延长,左室的损伤更为明显。Objective To investigate the use of the pressure-strain loop(PSL)in assessing left ventricular systolic work in subclinical patients with Sjogren’s syndrome(SS),in order to facilitate early detection of myocardial dysfunction.Methods A total of 50 patients with primary SS diagnosed in the Department of Rheumatology and Immunology Affiliated Hospital of Yangzhou University,along with 32 age-and sex-matched healthy volunteers,were selected for inclusion in the study.The global work index(GWI),global effective work(GCW),global dead work(GWW),global work efficiency(GWE),and peak strain dispersion(PSD)were obtained using PSL technology and compared between groups.Results The erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)levels in the SS group were higher compared to the control group.Additionally,the mitral annular plane systolic excursion(MAPSE)and E/e’ratio were lower in the SS group compared to the control group.These differences were found to be statistically significant(P<0.05).The GLS,GWI,GCW,and GWE values of the SS group were lower than those of the control group,while their GWW and PSD values were higher than those of the control group.These differences were statistically significant(P<0.05).GLS,GWI,GCW and GWE were found to have a negative correlation with the disease course,ESR and CPR.On the other hand,GWW and PSD showed a positive correlation with the disease course,ESR,and CPR.The repeatability analysis results showed that the intra-examiner and inter-examiner reproducibility were good.Conclusion PSL technique is a sensitive method for evaluating left ventricular systolic dysfunction and left ventricular systolic dyssynchrony.It can detect left ventricular systolic dysfunction earlier than clinical detection in patients with SS.With the progression of the disease,the damage to the left ventricle became more pronounced.

关 键 词：超声心动图 压力应变环 干燥综合征 左心室功能 

分 类 号：R593.2[医药卫生—内科学]