超声四维自动左心房定量技术评价不同疾病活动度强直性脊柱炎患者左心房容积及功能改变  

Ultrasound four-dimensional auto left atrial quantification technique for evaluating changes of left atrial volume and function in ankylosing spondylitis patients with different activity

作　　者：李思靓 袁建军[1] 张喜君[1] 鲁豫[1] 朱好辉[1] LI Siliang;YUAN Jianjun;ZHANG Xijun;LU Yu;ZHU Haohui(Department of Ultrasound,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院超声科,河南郑州450003

出　　处：《中国医学影像技术》2024年第12期1842-1846,共5页Chinese Journal of Medical Imaging Technology

基　　金：河南省医学科技攻关计划(SBGJ202102013)。

摘　　要：目的应用超声四维自动左心房定量(4D Auto LAQ)技术评估不同疾病活动度强直性脊柱炎(AS)患者左心房(LA)容积及功能改变。方法回顾性选取89例AS患者,根据AS疾病活动评分-C反应蛋白(ASDAS-CRP)将其分为缓解组(A组,n=20)、低活动度组(B组,n=25)、高活动度组(C组,n=23)及极高活动度组(D组,n=21);以54名年龄、性别相匹配的健康成人为对照组。比较组间常规超声心动图参数及4D Auto LAQ技术所获LA容积及应变参数;以多元有序logistic回归分析LA容积及应变参数与AS疾病活动度的相关性。结果组间二尖瓣口舒张早期血流峰值流速与二尖瓣环水平左心室侧壁舒张早期运动速度比值(E/e’)及LA最小容积(LAV_(min))、最大容积(LAV_(max))、收缩前容积(LAV_(pre))、射血分数(LAEF)、主动射血分数(LAaEF)及被动射血分数(LApEF)和储备期纵向应变(LASr-l)、管道期纵向应变(LAScd-l)、收缩期纵向应变(LASct-l)及储备期圆周应变(LASr-c)、管道期圆周应变(LAScd-c)、收缩期圆周应变(LASct-c)总体差异均有统计学意义(P均<0.001)。LAV_(min)与AS疾病活动度呈正相关(OR=7.106,B=1.96),LASr-l、LASct-l与AS疾病活动度呈负相关(OR=0.235、0.145,B=-1.44、-1.93)。结论随疾病活动度加重,AS患者LAV min逐渐增大,而LASr-l、LASct-l逐渐降低。Objective To explore changes of left atrial(LA)volume and function in ankylosing spondylitis(AS)patients with different activity by using ultrasound four-dimensional auto LA quantification(4D Auto LAQ)technique.Methods Eighty-nine AS patients were retrospectively selected and divided into remission group(group A,n=20),low activity group(group B,n=25),high activity group(group C,n=23)and very high activity group(group D,n=21)according to AS disease activity score-C reactive protein(ASDAS-CRP).Meanwhile,54 healthy adults with age and gender matched were recruited as control group.Conventional echocardiographic parameters and LA volume and strain parameters obtained with 4D Auto LAQ technique were compared among groups.Multiple ordinal logistic regression was used to analyze the correlations of LA volume and strain parameters with AS disease activity.Results The ratio of early diastolic peak flow velocity of mitral orifice to early diastolic velocity of lateral mitral annulus(E/e')and LA minimum volume(LAV_(min)),the maximum volume(LAV_(max)),presystolic volume(LAV_(pre)),ejection fraction(LAEF),active ejection fraction(LAaEF)and passive ejection fraction(LApEF)were all significantly different among groups,so were LA longitudinal strain during reservoir phase(LASr-l),conduit phase(LAScd-l),contraction phase(LASct-l)and circumferential strain during reservoir phase(LASr-c),conduit phase(LAScd-c)and contraction phase(LASct-c)(all P<0.001).LAV_(min)was positively correlated(OR=7.106,B=1.96),while LASr-l and LASct-l were negatively correlated with AS activity(OR=0.235,0.145,B=-1.44,-1.93).Conclusion With the increase of disease activity,LAV min in AS patients gradually increased,while LASr-l and LASct-l gradually decreased.

关 键 词：脊柱炎 强直性 超声心动描记术 四维 心房功能 左 

分 类 号：R593.23[医药卫生—内科学] R445.1[医药卫生—临床医学]