应用斑点追踪技术评价原发性干燥综合征患者右心室收缩功能

Application of speckle tracking technology evaluation of right ventricular systolic function in patients with primary Sjogren's syndrome

目的探讨应用斑点追踪技术(STI)评价原发性干燥综合征(pSS)患者右心室收缩功能的临床应用价值。方法将2014年12月至2015年10月中国医科大学附属盛京医院收治的30例pSS患者设为pSS组,并随机选取30例正常体检者作为对照组。应用常规超声心动图测量两组患者以下二维参数:右心室前后径(RVD)、右心室游离壁厚度(RVFW)、右心房横径(RATD)、右心室横径(RVTD)以及右心室面积变化分数(RVFAC)。应用STI技术对动态图像进行脱机分析,并测量两组患者右心室游离壁各节段(基底、中间、心尖)的收缩期纵向峰值速度(Vs)、峰值应变(Ss)及峰值应变率(SRs),比较两组患者各测值间的差异性。结果两组患者常规超声各项测值比较,差异均无统计学意义(P>0.05)。两组患者STI参数比较,pSS组右心室游离壁基底段的Vs、Ss、SRs及中间段的Ss、SRs较对照组减低,且差异均有统计学意义(P<0.05);而心尖段的Vs、Ss、SRs及中间段的Vs均值虽然较对照组减低,但差异无统计学意义(P>0.05)。结论应用STI能够早期发现pSS患者右心室收缩受损,是一种较为客观的新方法。

Objective To explore the application of speckle tracking technology evaluation（ STI） of right ventricular systolic function in patients with primary Sjogren＇s syndrome（ pSS）. Methods Clinical data of 60 cases were collected in Shengjing Hospital of China Medical University from December 2014 to October 2015. The total patients were randomly divided into 30 cases of patients with pSS in the pSS group and 30 cases of healthy volunteers in the control group. Using conventional echocardiography to measure two groups of patients with the following two dimensional parameters such as anterior and posterior right ventricular diameter（ RVD）,right ventricular free wall thickness（ RVFW）,right atrium transection diameter（ RATD）,right ventricular transection diameter（ RVTD） and right ventricular fractional area change（ RVFAC）. Application of STI to dynamic image for off-line analysis of right ventricular free wall segments（ basal,middle,apex）,longitudinal systolic peak velocity（ Vs）,peak strain（ Ss） and peak strain rate（ SRs）. The difference of parameters between two groups were compared. Results There was no significant difference in conventional echocardiography parameters between the two groups（ P〉0. 05）. The STI parameters between two groups were compared,respectively. The parameters of Vs,Ss,SRs in basal segment and those of the Ss,SRs in mid segment of right ventricular free wall were decreased in the pSS group compared to the control group（ P〈0. 05）. The mean parameters of Vs,Ss,SRs in apical segment and the mean Vs in mid segment were lower than the control group,while there was no statistical significance between two groups（ P〉0. 05）. Conclusion Application of STI is an early,objective and new method for evaluation of right ventricular systolic function in patients with pSS.