强直性脊柱炎患者心功能变化的研究

Assessment of the cardiac function in patients with ankylosing spondylitis

目的研究强直性脊柱炎(AS)患者心功能变化及其影响因素。方法采用多普勒超声心动图(UCG)检测140例AS患者心功能变化,并与30例健康对照组(NC)进行比较;观察AS患者实验室指标与心功能参数的相关性。结果 (1)AS组UCG检测结果异常率为33.56%,而NC组异常率为9.99%,差异有统计学意义(P<0.01)。(2)与NC组相比,AS患者左房室瓣口舒张晚期血流峰值(A峰)显著升高;舒张早期血流峰值(E峰)、射血分数(EF)、E/A比值显著降低,差异均有统计学意义(P<0.01)。(3)Spearman相关分析结果显示,AS组患者E峰与IL-35,A峰与心悸均呈显著正相关(P<0.05或P<0.01)。E峰与病程、血小板计数、免疫球蛋白G、红细胞沉降率、C反应蛋白均呈显著正相关(P<0.05或P<0.01),E/A比值与病程、IL-18均呈显著正相关(P<0.05或P<0.01),EF与病程、心悸呈显著负相关(P<0.05或P<0.01)。结论AS患者超声心动图检测结果异常率为33.56%,表现为E峰、EF、E/A比值显著降低,A峰显著升高且与实验室指标相关。

Purpose To study changes of the cardiac function in patients with ankylosing spondylitis （AS） and the correlation with other indicators .Methods The echocardiography （ UCG） was used to observe the changes of cardiac function in 140 patients with AS,and 30 healthy persons recruited as the normal control group .The correlation of laboratory indicators were observed .Results （1） The abnormal rate of UCG was 33.56%in the AS group and 9.99%in the NC group,with significant difference（P〈0.01）.（2）Compared with NC group,the blood flow velocity of mitral annulus during atrial contraction （ A） in AS patients was significantly higher ,while the blood flow velocity of mitral an-nulus during early diastole（E）,ejection fraction （EF） and E/A ratio in AS patients,were significantly decreased（P〈0.01）.（3） Spearman correlation analysis showed that there were positive correlation between E peak and IL -35（P〈0.05）,A peak and palpitations （P〈0.01） in patients withAS.There were negative correlation between E peak and course of the disease,PLT,IgG,ESR,CRP（P〈0.05 or P〈0.01）,The negative correlation was also found betweenE /A and course of the disease ,IL-18.EFwas negative correlated with the course of the disease and palpitations （ P〈0.05 or P〈0.01） .Conclusion Doppler echocardiography can be used to assess the cardiac function for the AS patients . The application of UCG technology is helpful for early detection of impaired cardiac function in the AS patients .