aCMQ技术评价系统性红斑狼疮患者左心室收缩功能  

Assessment of left ventricular systolic function in patients with systemic lupus erythematosus using aCMQ technique

作　　者：金子燃 李妍 刘璇 孙皓天 高静 JIN Ziran;LI Yan;LIU Xuan;SUN Haotian;GAO Jing(Department of Ultrasound,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121001,Liaoning,China)

机构地区：[1]锦州医科大学附属第一医院超声医学科,辽宁锦州121001

出　　处：《中国现代医生》2025年第5期57-61,共5页China Modern Doctor

摘　　要：目的应用自动心肌运动定量(automatic cardiac motion quantification,aCMQ)技术评价不同活动度系统性红斑狼疮(systemic lupus erythematosus,SLE)患者左心室收缩功能损害的价值,并探讨左心室应变参数与临床实验指标、SLE疾病活动指数(systemic lupus erythematosus disease activity index,SLEDAI)的相关性。方法选取2023年11月至2024年8月于锦州医科大学附属第一医院确诊的80例SLE患者作为研究对象,SLEDAI<10分为狼疮轻度组(n=46),SLEDAI≥10分为狼疮中重度组(n=34)。随机选取同期体检的40名健康志愿者作为对照组。通过常规超声心动图及aCMQ技术获得相关参数。结果三组受试者的左心室整体纵向应变(left ventricular global longitudinal strain,LVGLS)、心尖两腔心纵向应变(apical two-chamber longitudinal strain,AP2LS)、心尖三腔心纵向应变(apical three-chamber longitudinal strain,AP3LS)、心尖四腔心纵向应变(apical four-chamber longitudinal strain,AP4LS)比较,差异均有统计学意义(P<0.05)。狼疮中重度组的左心室整体环向应变(left ventricular global circumferential strain,LVGCS)与另外两组比较,差异有统计学意义(P<0.05),Pearson相关分析结果表明LVGLS、AP2LS、AP3LS、AP4LS及LVGCS均与补体C3、补体C4呈正相关,而与抗心磷脂抗体(anticardiolipin antibody,ACA)IgA、IgG、IgM及血红细胞沉降率、超敏C反应蛋白呈负相关,SLEDAI与LVGLS、AP2LS、AP3LS、AP4LS呈负相关,与LVGCS无明显相关性。结论aCMQ技术可早期发现SLE患者左心室收缩功能的变化,且随着疾病活动度越高,左心室收缩功能损害越重。左心室应变参数和临床实验指标、SLEDAI间较好的相关性可能有助于更好地评估SLE患者的心脏受累情况。Objective To evaluate the value of left ventricular(LV)systolic function impairment in patients with different activity levels of systemic lupus erythematosus(SLE)by applying automatic myocardial motion quantification(aCMQ)technique,and to explore the correlation between left ventricular strain parameters and clinical laboratory indexes,systemic lupus erythematosus disease activity index(SLEDAI).Methods A total of 80 patients diagnosed with SLE from November 2023 to August 2024 in the First Afticiated Hospital of Jinzhou Medical University were selected and divided into two groups:40 cases with SLEDAI<10points were in mild lupus group,34 cases with SLEDAI≥10points were in moderately severe lupus group.Forty healthy volunteers for physical examination at the same time were randomly selected as control group,relevant parameters were obtained by conventional echocardiography and aCMQ technique respectively.Results aCMQ technique related parameters were compared,and the differences in left ventricular global longitudinal strain(LVGLS),apical two-chamber longitudinal strain(AP2LS),apical three-chamber longitudinal strain(AP3LS),and apical four-chamber longitudinal strain(AP4LS)were statistically significant in all three groups(P<0.05).The differences in left ventricular global circumferential strain(LVGCS)in lupus moderate-severe group were statistically significant when compared with other two groups(P<0.05),Pearson correlation analysis showed LVGLS,AP2LS,AP3LS,AP4LS and LVGCS were positively correlated with complement 3 and complement 4,and negatively correlated with anticardiolipin antibody(ACA)IgA,IgG,IgM,and sedimentation,and ultrasensitive C-reactive protein,and the SLEDAI was correlated with LVGLS,AP2LS,AP3LS,AP4LS were negatively correlated,and there was no significant correlation with LVGCS.Conclusion aCMQ technique can detect changes in LV systolic function in SLE patients at an early stage,and the impairment of LV systolic function is more severe with higher disease activity.Better correlation between LV

关 键 词：系统性红斑狼疮 自动心肌运动定量技术 SLE疾病活动指数 左心室收缩功能 

分 类 号：R445.1[医药卫生—影像医学与核医学]