原发性干燥综合征对左心结构及功能影响

Effect of primary Sjgren's syndrome on left ventricular structure and function

目的探讨原发性干燥综合征对左心结构及功能的影响。方法选取成都市第三人民医院2010年10月至2014年2月收治的原发性干燥综合征患者120例。另外,选择与患者组年龄及性别匹配的健康对照组120例。经胸超声心动图检测左心大小、左心室收缩功能、舒张功能、肺动脉压、瓣膜反流及心包积液。结果病例组与对照组相比,左心房(LAD)增大,差异有统计学意义(P<0.05);两组左心室(LVD)比较,差异无统计学意义(P>0.05);两组二尖瓣口舒张晚期血流速度峰值(A)、二尖瓣口舒张早期血流速度峰值/二尖瓣口舒张晚期血流速度峰值(E/A)、二尖瓣环舒张早期运动速度峰值(Em)、二尖瓣环舒张晚期运动速度峰值(Am)、Em/Am、E/Em比较,差异均有统计学意义(P<0.05);两组左心室射血分数比较,差异无统计学意义(P>0.05)。病例组心包积液及肺动脉高压较对照组发病率增高;二、三尖瓣反流发生率大于对照组,差异有统计学意义(P<0.05)。结论原发性干燥综合征易导致左心结构及功能受累。左心室舒张功能不全、肺动脉高压、心包积液、瓣膜反流、左心房增大是常见受损表现。需重视其潜在的心血管风险。

Objectives To explore the effect of primary Sjogren＇s syndrome （pSS） on left ventricular structure and function. Methods The study included 120 patients with pSS and 120 age/sex-matched healthy controls selected in The Third People＇s Hospital of Chengdu from October 2010 to February 2014. Diameters of left ventricle （LVD） and left atrium （LAD）, left ventricular systolic function, left ventricular diastolic function, pulmonary artery pressure, valvular regurgitation and pericardia1 effusion （PE） were messured by echocardiography in all the patients and controls. Results Compared with control group, LAD in patients increased （P〈0.05）, but LVD in patients had no significant difference （P〉0.05）. Peak late diastolic mitral flow velocity （A）, peak early diastolic mitral flow velocity/peak late diastolic mitral flow velocity （E/A）, peak early diastolic mitral annulus velocity （Em）, peak late diastolic mitral annulus velocity （Am）, Em/Am and E/Era had statistical differences between the two groups （P〈0.05）. Left ventricular ejection fraction （LVEF） had no significant difference between the two groups （P〉0.05）. There were significant differences between patients and controls in PE, pulmonary hypertension （PHP） and valvular regurgitation （P〈0.05）. Conclusions Our study confirms that pSS can easily affect left ventricular structure and function. Left ventricular diastolic dysfunction （LVDD）, PHP, PE, valvular regurgitation and chamber enlargement are common impaired performance. It suggests that cardiovascular risks should be awared.