系统性红斑狼疮患者左心功能的应变和应变率研究

Study of strain and strain rate imaging in systemic lupus erythematosus

目的 探讨应变和应变率显像评价系统性红斑狼疮（SLE）患者左心功能的临床应用价值.方法 60例正常人与62例SLE患者均接受常规超声及组织多普勒检测,获取二尖瓣血流E/A值、左室短轴缩短率（LVFS）、左室射血分数（LVEF）及左室心肌的收缩期及舒张期峰值应变和应变率.结果 ①SLE组和正常对照组E/A值、LVFS及LVEF无明显差异（P＞0.05）;SLE组心肌的收缩期应变、应变率峰值低于正常对照组,但差异无统计学意义（P＞0.05）.②SLE组舒张期应变率峰值低于正常对照组且差异有统计学意义（P＜0.01）.③SLE组抗心肌抗体（AHA）阳性者心肌舒张期应变率峰值低于AHA阴性者（P＜0.05）.结论 应变及应变率与AHA结合可以敏感检测SLE患者左心功能的早期损害.

Objective To investigate the diagnosis value of the tissue strain imaging in myocardial dysfunction in systemic lupus erythematosus （SLE）. Methods Sixty-two patients and sixty controls underwent conventional and tissue Doppler echocardiography. Peak strain and strain rate value during systolic and diastolic phases as well as E/A, left ventricular fraction shortening （LVFS）, left ventricular ejection fraction（LVEF） were measured in both SLE and the control groups. Results ①E/A,LVFS and LVEF did not differ between SLE patients and controls（ P 〉0.05）. The systolic peak strain and strain rate of SLE patients were lower than those of controls but without significant differences（ P 〉0.05）. ②The diastolic peak strain and strain rate of SLE patients were significantly lower than those of controls （P 〈0.01）. ③ The diastolic peak strain and strain rate of antiheart antibody （AHA） positive patients were significantly lower than those of negative ones（ P 〈0.05）. Conclusions Strain and strain rate combining with AHA can sensitively detect myocardial dysfunction of SLE.