二维斑点追踪成像技术在评价系统性红斑狼疮患者左心室收缩功能早期变化的应用

Application of two-dimensional speckle tracking echocardiography in the evaluation of early changing of left ventricular systolic function in patients with systemic lupus erythematosus

目的探讨基于二维斑点追踪成像技术评价系统性红斑狼疮患者左心室收缩功能改变的应用研究。方法选择2014年6月至2017年6月,香港大学深圳医院诊治的88例系统性红斑狼疮患者,按病程差异分为Ⅰ组44例(病程<5年)和Ⅱ组44例(病程5~10年),同期入组30例健康志愿者作为对照组,所有入组对象均行超声心动图检查,测量左心室舒张期末容积(LVEDV)、左心室收缩期末容积(LVESV)、左心室射血分数(LVEF),并采用二维斑点追踪成像技术获取并比较三组对象的纵向(LS)、径向(RS)和圆周(CS)的整体收缩期峰值应变,对数值进行统计学分析。结果对照组、Ⅰ组、Ⅱ组LVEDV、LVESV、LVEF差异无统计学意义(F=1.036、0.871、0.956,P>0.05);NC组、Ⅰ组、Ⅱ组组间LS、CS、RS差异有统计学意义(F=4.042、3.873、4.702,P<0.05),Ⅰ组和Ⅱ组LS、CS较对照组下降(P<0.05),Ⅱ组RS较对照组下降(P<0.05)。结论二维斑点追踪成像技术检测系统性红斑狼疮患者左心室心肌纵向及圆周收缩功能异常,较普通超声心动图检查客观、敏感,为早期诊断左心室功能改变提供新指标。

Objective To assess the application of two-dimensional speckle tracking echocardiography on the evaluation of early changing of left ventricular systolic function in patients with systemic lupus erythematosus. Methods Total 88 patients with systemic lupus erythematosus treated in the University of Hong KongShenzhen Hospital were enrolled in the study from June 2014 to June 2017,and were divided into group I（44 cases with disease duration 5 years）and group Ⅱ（44 cases with disease duration of 5 to 10 years）.Meanwhile,30 healthy volunteers were enrolled as normal control（NC）.All subjects were received echocardiography and were measured for left ventricular end-diastolic volume（LVEDV）,left ventricular end-systolic volume（LVESV）and left ventricular ejection fraction（LVEF）.The longitudinal（LS）,radial（RS）and circumference（CS）of the overall peak systolic strains were evaluated by two-dimensional speckle tracking echocardiography. Results There were no significant differences in LVEDV,LVESV and LVEF between NC,group Ⅰ and group Ⅱ（F=1.036,0.871,0.956,P〈0.05）.However,the differences of LS,CS and RS among subjects in NC group,group Ⅰ and group Ⅱ were statistically significant（F=4.042,3.873,4.702,P〈0.05）.The LS and CS of patients in groupⅠ and groupⅡ were much lower than that of normal controls（P〈0.05）,and the RS of patients in group Ⅱ was much lower than that of controls（P〈0.05）. Conclusions The two-dimensional speckle tracking echocardiography can be applied to trace the early changing of left ventricular systolic function of patients with systemic lupus erythematosus especially in LS and CS,which is more sensitive and objective compared with regular echocardiography.