运用2D-STE评估系统性红斑狼疮合并肺动脉高压患者右心房功能及其危险因素分析  

Analysis on assessment for right atrial function and its risk factors of patients with SLE and PAH by using 2D-STE

作　　者：师钰婧 许建萍[2] Shi Yujing;Xu Jianping(School of Medical Imaging,Shanxi Medical University,Taiyuan 030000,China;Department of Ultrasound Image,First Hospital of Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学医学影像学院,太原030000 [2]山西医科大学第一医院超声影像科,太原030000

出　　处：《中国医学装备》2025年第3期53-57,共5页China Medical Equipment

摘　　要：目的:运用二维斑点追踪超声心动图(2D-STE)评价系统性红斑狼疮(SLE)患者的右心房(RA)功能,并对可能影响右心房功能的指标进行相关性分析。方法:选取2022年9月至2023年2月在山西医科大学第一医院确诊为SLE的81例患者作为病例组,依据肺动脉收缩压(PASP)值分为A组(PASP≤30 mmHg)、B组(30mmHg<PASP<50mmHg)和C组(PASP≥50mmHg)。另选同期与病例组性别相匹配的28名健康志愿者为健康对照组。各组均行常规超声心动图检查获取三尖瓣反流速度(TR)、下腔静脉(IVC)的最大径及塌陷率,并估算患者的右房压及PASP;并行2D-STE获取储存期应变(RASr)、管道期应变(RAScd)、收缩期应变(RASct)。比较分析各组上述参数间的差异,并对可能影响右心房功能的红细胞计数、补体C3、血沉、病程、尿酸、C反应蛋白、体重等指标进行相关性分析。结果:SLE患者A、B、C组的RASct值均减低,反向应变分别为(14.7±8.5)、(13.7±7.6)和(13.2±6.2),与健康对照组比较差异有统计学意义(t=-4.118、-5.129、-6.740,P<0.05),C组RASr、RAScd值低于健康对照组,差异有统计学意义(t=2.443、-4.727、P<0.05);C组的RAScd值均低于A组和B组,差异有统计学意义(t=-1.361、-1.712,P<0.05)。控制变量为RASr时,红细胞计数呈负相关(r=-0.278,P=0.012)。控制变量为RASct时,红细胞计数呈正相关、血沉呈负相关(r=0.297、-0.264,P=0.018)。尿酸及C反应蛋白为右心房功能的独立影响因素,且均为影响右心房功能的危险因素。结论:2D-STE可识别肺压正常但已存在右房功能受损的SLE患者;红细胞计数与SLE-PAH患者RASr、RASct功能受损相关,血沉与SLE-PAH患者RASct功能受损相关;尿酸及C反应蛋白的升高可以预测SLE-PAH患者RA功能减低。Objective:To evaluate the function of right atrium(RA)in patients with systemic lupus erythematosus(SLE)by using two-dimensional speckle tracking echocardiography(2D-STE),and to analyze the correlation between the indicators that might affect the RA function.Methods:A total of 81 patients,who were diagnosed as SLE in the First Hospital of Shanxi Medical University from September 2022 to February 2023,were selected as the case group.According to the pulmonary artery systolic pressure(PASP),the case group was further divided into group A(PASP≤30 mmHg),group B(30 mmHg<PASP<50 mmHg),and group C(PASP≥50 mmHg).At the same time,28 healthy volunteers who matched with the patients of case group were selected as the health control group.Conventional echocardiography examination was performed in all groups to obtain tricuspid regurgitation(TR)velocity,maximum diameter of inferior vena cava(IVC)and collapse rate,and right atrial pressure and PASP of patients were estimated.The 2D-STE was used to obtain strain during reservoir phase(RASr),strain during conduit phase(RAScd)and strain during contraction phase(RASct).The differences of the above parameters among all groups were compared and analyzed,and correlation analysis was performed on red blood cell count,complement C3,erythrocyte sedimentation,disease course,uric acid,C-reactive protein,body weight and other indicators that might affect function of right atrium.Results:Compared with the health control group,the RASct values of groups A,B and C decreased(t=-4.118,-5.129,-6.740,P<0.05),and the RASr and RAScd of group C were lower than those of the health control group,with statistical significance(t=2.443,-4.727,P<0.05).The RAScd of group C was lower respectively than that of group A and group B,and the differences were statistically significant(t=-1.361,-1.712,P<0.05).When the control variable was RASr,the red blood cell count was negatively correlation(r=-0.278,P=0.012).When the control variable was RASct,the red blood cell count appeared positive correlation,and the

关 键 词：系统性红斑狼疮 二维斑点追踪 右心房功能 肺动脉高压 

分 类 号：R445.1[医药卫生—影像医学与核医学]