核素心室造影检测SLE心脏损害与超声心动图对比研究

Comparative Study of Radionuclide Ventriculography and Echocardiography in Assessment of Cardiac Involvement in Patients with Systemic Lupus Erythematosus

目的探讨核素心室造影在探测SLE心脏损害的应用价值,并与超声心动图对比研究。方法对40例SLE患者和15例正常人进行核素心室造影,并对SL E患者进行超声心动图检查。结果SLE患者左室收缩功能参数,如左室射血分数(LVEF)、高峰射血率(PER)和前1/3射血分数(1/3EF)与对照组比较,差异均无显著性(P>0.05),仅1/3ER比对照组降低,差异有极显著性(P<0.01)。但患者舒张功能参数如高峰充盈率(PFR)、前1/3充盈率(1/3FR)、前1/3充盈分数(1/3FF)均降低,差异有显著性(P<0.05),且活动期降低更明显。患者左室相位标准差(LVSDP)增大,提示心肌收缩运动协调性降低。SLE患者心脏损害检出阳性率高于超声心动图(P<0.01)。结论核素心室造影可以客观评价SLE患者左心室功能,在检测SLE心脏受累中具有一定的临床价值。

Objective To investigate cardiac involvement in patients with systemic lupus erythematosus using radionuclide ventriculography and Echocardiography. Methods Forty patients with clinically active（ n = 27 ）, inactive （ n = 13 ） systemic lupus erythematosus and 15 healthy controls were examined by radionuclide ventriculography, and Fifty patients were detected by echocardiography. Results Left ventricular（LV） systolic function paramenters such as LVEF, 1/3EF and PER were not significantly different from healthy controls（ n = 15 ）. LV diastolic function parameters, including peak filling rate （PFR）,filling fraction of the first third diastolic （1/3FF）and filling rate of the first third （1/3FR） decreased statistically in patients with SLE （ P 〈0. 05）, especially in active stage. Standard deviation of the peak （SDP） of LV in patients increased. The diagnostic Sensistivities of radionuclide ventriculography had significant differences in patients with clinically active and inactive compared with echocardiography. Conclusion Radionuclide ventriculography can be used to evaluate cardiac function in SLE patients and thereby helps the diagnosis of the myocardial damage in the disease.