QAS及X-strain技术评价系统性红斑狼疮患者颈动脉弹性

Evaluation on elasticity of carotid artery with QAS and X-strain technique in patients with systemic lupus erythematosus

目的应用血管硬度检测(QAS)技术及应变和应变率成像(X-strain)技术定量评价系统性红斑狼疮(SLE)患者颈动脉弹性。方法根据病史将77例SLE患者分为SLE 1组(病史<5年,46例)和SLE 2组(病史≥5年,31例),另选取40名健康志愿者作为对照组。采用常规超声、QAS技术和X-strain技术检测双侧颈动脉,比较各组间常规超声参数、QAS技术和X-strain技术参数差异,分析各参数间的相关性。结果 SLE 1组与对照组内-中膜厚度(IMT)、弹性系数α、弹性系数β、脉搏波速度和动脉反射波增强指数差异无统计学意义(P均>0.05),SLE 2组上述参数与对照组和SLE 1组相比明显增高(P均<0.05);3组间最大圆周应变及圆周应变率比较差异均有统计学意义(P均<0.05),且随病程延长逐渐减低;颈动脉IMT与QAS参数、X-strain参数之间具有明显相关性。结论应用QAS和X-strain技术能早期检测SLE患者颈动脉弹性功能改变,对预防和干预SLE患者心血管事件非常重要。

Objective To observe the value of quantitative arterial stiffness （QAS） and X-strain technique in assessment of changes for carotid artery elasticity in patients with systemic lupus erythematosus （SLE）. Methods Seventy-seven patients with SLE were divided into SLE 1 group （duration〈5 years, n=46） and SLE 2 group （duration≥5 years, n=31） . Forty healthy volunteers were enrolled as control group. Ultrasound, QAS and X-strain techique were performed to evaluate carotid arterial elastic function, and the parameters were compared among groups. Correlation of these parameters was analyzed. Results There was no difference of intima-media thickness （IMT）, elastic coefficient α, elastic coefficient β, pulse wave velocity nor augmentation index between control group and SLE 1 group （all P〉0.05）. The above parameters of SLE 2 group significantly increased compared with control group and SLE 1 group （all P〈0.05）. The maximum value of circumferential strain and circumferential strain rate were significantly different among three groups （all P〈0.05）, which decreased along with the course. IMT, QAS parameters and X-strain parameters were significantly correlated each other. Conclusion QAS and X-strain technology can early detect changes of carotid arterial elasticity in SLE patients, which are important for prevention and intervention of cardiovascular events for SLE patients.