Tei指数评价系统性红斑狼疮患者左右心室功能的研究

Value of Tei index assessing left and right ventricular function in patients with systemic lupus erythematosus

目的:探讨应用组织多普勒(TDI)分别测量左、右心室Tei指数评价系统性红斑狼疮(SLE)患者左、右心室功能的临床价值。方法:20例健康成年人作为健康对照组(A组),40例SLE患者,其中合并轻度肺动脉高压者20例作为B组,合并中度以上肺动脉高压者20例作为C组。应用TDI记录二、三尖瓣环的频谱图,测量相关时间间期,计算出左、右心室Tei指数。结果:①与A组比较,B、C两组右室等容舒张时间[IRT,(46.95±14.42)ms比(69.65±24.57)ms比(94.30±23.56)ms]、等容收缩时间[ICT,(41.70±12.33)ms比(55.60±15.14)ms比(79.35±18.84)ms]明显延长,射血时间[ET,(297.95±26.57)ms比(273.35±34.46)ms比(233.00±30.84)ms]明显缩短,右室Tei值[RV-Tei,(0.30±0.10)比(0.48±0.20)比(0.78±0.27)]明显增大(P<0.05或<0.01);与B组比较,C组右室IRT、ICT显著延长,ET显著缩短,Tei值显著增大(P<0.05);②与A组及B组相比,C组左室IRT[(73.95±14.22)ms比(76.75±16.36)ms比(95.00±15.30)ms]显著延长,ET[(288.05±26.55)ms比(274.85±33.14)ms比(254.25±31.08)ms]显著缩短,Tei指数[(0.44±0.09)比(0.49±0.14)比(0.61±0.14)]显著增加(P<0.05或<0.01),ICT差异无显著性;B组与A组相比,左室IRT、ICT、ET及Tei值之间的差异均无显著性。结论:①Tei指数是评价系统性红斑狼疮患者心室整体功能敏感而又准确的多普勒超声指标;②右室压力负荷增加对左室功能有明显影响。

Objective： To explore value of Tei index assessing left and right ventricular in patients with systemic lupus erythematosus （SLE）, the Tei index was measured by tissue Doppler image （TDI）. Metbods：A total of 20 healthy a-dults were regard as healthy control group （group A）. There were 40 SLE patients, including 20 cases complicated with mild pulmonary artery hypertension （PAH,regard as group B） and 20 cases complicated with moderate to se-vere PAH （regard as group C）. TDI was used to record frequency spectrogram of mitral and tricuspid annulus, rela-tive time intervals were measured, and left and right ventricular Tei indexes were calculated. Results：① Compared with group A, there were significant increase in right ventricular isovolumic relaxation time [IRT, （46.95 ± 14. 42） ms vs. （69.65 ± 24.57）ms vs. （94. 30 ± 23.56） ms], isovolumetric contraction time [ICT, （41.70 ± 12.33） ms vs. （55.60± 15.14）ms vs. （79.35 ± 18. 84）ms] and Tel index [RV-Tei, （0. 30 ± 0. 10） vs. （0. 48 ± 0.20） vs. （0. 78 ± 0.27）], and significant decrease in ejection time lET, （297.95 ± 26.57）ms vs. （273.35 ± 34.46）ms vs. （233.00 ± 30.84）ms] in group B and C, P〈0.05 or 〈0.01; compared with group B, there were significant increase in IRT, ICT and Tei index, and significant decrease in ET in group C, P〈0. 05;② compared with group A and B, there were significant increase in left ventricular IRT [（73.95 ± 14. 22）ms vs. （76.75 ± 16. 36）ms vs. （95.00 ± 15.30）ms] and Tel index [（0.44 ± 0.09） vs. （0.49 ± 0.14） vs. （0.61 ± 0.14）], and significant decrease in ET [（288. 05 ± 26. 55）ms vs. （274. 85 ± 33. 14）ms vs. （254. 25 ± 31.08）ms] in group C （P〈0. 05 or 〈0. 01） ; there were no signifi-cant difference in left ventricular IRT, ICT, ET and Tei index between group B and A. Conclusion：① Tel index is a sensitive and accurate Doppler ultrasound index assessing ventricular allomeric function in patients with systemic lu-pus erythematosus; ② Increased right ventricular pressure load has significant influence on left ventricular function.