三维斑点追踪成像对系统性硬化病合并肺动脉高压患者右心室功能的评价  

Three-Dimensional Speckle Tracking Imaging for Assessment of Right Ventricular Function in Systemic Sclerosis with Pulmonary Arterial Hypertension

作　　者：胡文姝 周畅[1] 聂淑婷 邵袁缘 李心怡 谌典 张奥懿 Hu Wenshu;Zhou Chang;Nie Shuting;Shao Yuanyuan;Li Xinyi;Shen Dian;Zhang Aoyi(The First College of Clinical Medical School,China Three Gorges University,Department of Ultrasound,Yichang Central People's Hospital,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院,宜昌市中心人民医院超声科,湖北省宜昌市443003

出　　处：《中国超声医学杂志》2024年第11期1245-1249,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨三维斑点追踪成像(3D-STI)评估系统性硬化病(SSc)合并肺动脉高压(PAH)患者右心室功能的临床价值。方法回顾性选取收治的68例SSc患者,将其分为合并PAH组38例[PAH(+)组]和未合并PAH组30例[PAH(-)组],对照组为40例健康志愿者。3D-STI获取右心室面积变化分数(RVFAC)、右心室游离壁纵向应变(RVFWLS)、右心室整体纵向应变(RVGLS)、右心室每搏输出量(RVSV)和右心室射血分数(RVEF)等参数。比较各组差异,应用Pearson相关分析法分析右心室参数与肺动脉收缩压(PASP)的关系。结果与对照组相比,PAH(+)组及PAH(-)组右心室功能参数降低(P<0.05)。与PAH(-)组相比,PAH(+)组RVFWLS、RVGLS绝对值降低(P<0.05)。Pearson相关分析显示,PASP与TAPSE、s′、RVFAC、RVEF、RVFWLS、RVGLS绝对值均呈负相关(r=-0.316,-0.357,-0.291,-0.296,-0.537,-0.436,P<0.05),且与RVFWLS相关性最好。结论3D-STI可有效评估SSc合并PAH患者右心室功能,为此类患者的风险分层提供了一种有价值的影像学检查方法。Objective To investigate the clinical utility of three-dimensional speckle tracking imaging(3D-STI)for assessing right ventricular function in patients with systemic sclerosis(SSc)and pulmonary arterial hypertension(PAH).Methods A total of 68 systemic sclerosis patients were retrospectively selected as the study group,which was divided into 38 cases combined with PAH[PAH(+)group]and 30 cases without PAH[PAH(-)group],and another 40 healthy volunteers were selected as the control group in the same period.3D-STI was applied to obtain parameters such as right ventricular fractional area change(RVFAC),right ventricular free wall longitudinal strain(RVFWLS),right ventricular global longitudinal strain(RVGLS),right ventricular stroke volumes(RVSV)and right ventricular ejection fraction(RVEF).The differences between the groups were compared,and Pearson correlation analysis was applied to analyze the relationship between right ventricle-related parameters and pulmonary artery systolic pressure(PASP).Results Compared with the control group,right ventricular functional parameters were reduced in the PAH(+)group and the PAH(-)group(P<0.05).Absolute values of RVFWLS and RVGLS were impaired in the PAH(+)group compared with the PAH(-)group(P<0.05).Pearson correlation analysis showed that PASP was negatively correlated with absolute values of tricuspid annular plane systolic excursion(TAPSE),s′,RVFAC,RVEF,RVFWLS and RVGLS(r=-0.316,-0.357,-0.291,-0.296,-0.537,-0.436,P<0.05),and the correlation with RVFWLS was the best.Conclusions 3D-STI is an effective tool for assessing right ventricular dysfunction in SSc patients with PAH and provides a valuable imaging method for risk stratification in this patient population.

关 键 词：三维斑点追踪成像 右心室功能 系统性硬化病 肺动脉高压 

分 类 号：R445.1[医药卫生—影像医学与核医学] R593.2[医药卫生—诊断学] R544.1[医药卫生—临床医学]