血流向量成像技术评价系统性红斑狼疮患者左室舒张功能的研究

A clinical study of left ventricular diastolic function in systemic lupus erythematosus patients evaluated by vector flow mapping

目的应用血流向量成像技术观察系统性红斑狼疮(SLE)患者舒张期左室血流动力学变化,探讨其早期评价SLE患者左室舒张功能受损的临床价值。方法选取50例SLE患者为病例组,50例健康志愿者为对照组,测量两组左室心尖段、中间段、基底段的平均能量损耗(aEL),以及舒张期不同时相(快速充盈期、减慢充盈期、心房收缩期)循环值的变化,比较两组上述参数的差异。分析上述参数与二尖瓣口舒张早期血流峰值速度与二尖瓣环舒张早期运动峰值速度比值(E/e’)的相关性。结果组间比较,病例组心房收缩期心尖段、中间段、基底段aEL均较对照组显著增高,差异均有统计学意义(均P<0.05);组内比较,两组同一时相基底段至心尖段的aEL均呈递减趋势,差异均有统计学意义(均P<0.05)。病例组快速充盈期二尖瓣前叶循环值明显低于对照组,心房收缩期二尖瓣后叶循环值明显高于对照组,差异均有统计学意义(均P<0.05)。病例组心房收缩期基底段aEL与E/e’呈正相关(r=0.65,P<0.01)。结论血流向量成像技术能准确反映SLE患者舒张期左室血流动力学变化,为评价SLE患者左室舒张功能受损程度提供量化指标。

Objective To investigate the application value of vector flow mapping(VFM)in the assessment of diastolic left ventricular hemodynamics features in systemic lupus erythematosus(SLE)patients,and to explore the clinical value of early evaluation of left ventricular diastolic function in patients with SLE. Methods Fifty patients with SLE were enrolled in the case group,50 healthy volunteers were enrolled in the control group.The quantitative parameters,including average energy loss(aEL) of the left ventricular apical segment,the middle segment,and the basal segment and the changes in the cycle values of the different phases of the diastolic phase(fast filling period,slowing filling period,and atrial systole)were measured and the differences of the above parameters were compared between the two groups.And correlationship between the above parameters and the ratio of the peak velocity of early diastolic systolic blood flow and the peak velocity of mitral annulus early dilation(E/e’)were analyzed. Results ①Compared to the control group,aEL was significantly higher in case group at three segments of atrial systole (all P<0.05),intra-group comparison showed the aEL of the three segments in the same phase showed a decreasing trend,and the difference was statistically significant(all P<0.05).②In case group,circulation value in rapid filling phase of anterior mitral valve was lower than that of the control group,but higher in slow filling phase of posterior mitral valve,the difference was statistically significant(all P<0.05).③There was a positive correlation between aEL and E/e’at basal segment of atrial systole in case group(r=0.65,P<0.01). Conclusion VFM can analyze left ventricular hemodynamics features in SLE patients accurately,it may provide quantitative indicators for assessing the degree of left ventricular diastolic function in patients with SLE.