三维超声在系统性红斑狼疮并肺动脉高压患者右心房功能评价中的应用

Three-dimensional echocardiography in the evaluation of right atrial function in pulmonary artery hypertension patients with systemic lupus erythematosus

目的:应用三维超声评价系统性红斑狼疮(SLE)患者不同程度肺动脉高压(PAH)时右心房功能的改变。方法:依据临床SLE的诊断标准将诊断明确的102例患者分为3组:A组为无PAH(肺动脉收缩压≤30mmHg,1mmHg=0.133kPa,37例),B组为轻度PAH(30mmHg<肺动脉收缩压<50mmHg,34例),C组为中重度PAH(50mmHg≤肺动脉收缩压,31例)。另筛选出相同条件下30例检查正常者为对照组。对4组患者行常规二维及三维超声心动图检查,记录并分析右心房相关参数。结果:A组指标与对照组相比差异无统计学意义(P>0.05)。B、C组主动排空容积指数(SVIact)较对照组增高,并且SVI随着肺动脉收缩压的增高而呈增高趋势。B、C组总排空分数指数(EFI)及被动排空分数指数(EFIpas)均低于对照组,并且随肺动脉收缩压的增高呈减低趋势(均P<0.05)。B、C组主动排空分数指数(EFIact)高于对照组(均P<0.05)。结论:随着SLE患者肺动脉压不同程度的增高,三维超声可以客观评价其右心房功能的变化。

Objective：To evaluate the right atrial function in patients with systemic lupus erythematosus （SIZE） com- plicated with different severity of pulmonary artery hypertension （PAH） by three dimensional echocardiography （3DE）. Methods： A total of 102 patients with clinical diagnosis of SLE were divided into 3 groups： SLE patients without PAH were included into group A （PASP^30 mmHg, 1 mmHg=0. 133 kPa, n=37）, with mild PAH were included into group B （30 mmHg〈PASP〈50 mmHg, n=34）, with moderate to severe PAH were included into group C （50 mmHg ≤PASP, n=31）. Thirty matched healthy adults were selected as the control group. Conventional 2DE and 3DE were performed in all groups to record and analyze the right atrial related parameters. Result： There were no significant differ- ences of all the parameters between group A and control group. The active stroke volume index （SVIact） was increased with the raised PAH, and it was significantly increased in group B and group C when compared with the control group. While with the increasing of PASP, the total empty fraction index （EFI） and passive empty fraction index （EFIpas） were both decreased, and the EFI and EFIpas in group B and group C were significantly decreased in comparison of the control group （all P〈0.05）. Active empty fraction index （EFIact） in group B and group C significantly increased compared with the control group （all P〈0.05）. Conclusion： 3DE could objectively estimate the right atrial function of SLE patients with different severity PAH.