速度向量成像技术对系统性红斑狼疮患者左心房收缩功能的评估

Evaluation of left atrial systolic function with velocity vector imaging in patients with systemic lupus erythematosus

目的 采用速度向量成像(VVI)技术对系统性红斑狼疮(SLE)患者左心房收缩功能进行评价。方法 选择2018年7月至2020年12月于内蒙古自治区人民医院确诊的SLE患者55例,其中男性16例,女性39例;年龄18~51岁,平均年龄37.0岁;病程1.0~8.9年,平均病程4.43年。依据病程将患者分为A组(病程≤5年)30例、B组(病程> 5年)25例,并选用30例健康者作为对照组C组。采用VVI技术结合心电图观察并比较A组、B组、C组左心房最小容积(LAVmin)、左心房P容积(LAVp)、左心房主动排空分数(LAAEF)、左心室舒张晚期左心房峰值应变率(SRa)。结果 A组与C组相比,LAVmin、LAVp、LAAEF差异无统计学意义(P> 0.05);B组与A组和C组相比,B组LAVmin [(16.59±1.35) mL]、 LAVp增高[(26.56±3.56) mL],LAAEF[(37.82±5.77)%]降低,差异均有统计学意义(P <0.05)。A组与C组相比,A组心肌12个节段SRa均较C组增高(P <0.05);B组与A组和C组相比,B组心肌12个节段SRa均低于A组和C组(P <0.05)。结论 VVI技术较常规超声显示左心房功能变化更敏感,可准确评估SLE患者左心房收缩功能的改变。

Objective To evaluate left atrial systolic function in patients with systemic lupus erythematosus(SLE) by velocity vector imaging(VVI). Methods From July 2018 to December 2020, a total of 55 patients diagnosed with SLE were enrolled,which included 16 males and 39 females, aged 18-51 years old with mean age of 37.0 years old;disease duration wax 1.0-8.9 years with mean disease duration of 4.43 years. According to disease duration,all of them were divided into group A(n =30, disease duration ≤ 5 years) and group B(n = 25, disease duration > 5 years), and 30 healthy subjects were set as control(group C). The left atrial minimum volume(LAVmin), left atrial P volume(LAVp), left atrial active ejection fraction(LAAEF) and left ventricular late diastolic peak strain rate(SRa) in group A, group B and group C were observed and compared by VVI technology combined with electrocardiogram. Results There was no significant difference in LAVmin, LAVp and LAAEF be tween group A and group C(P > 0.05);Compared with group A and group C, significantly increased LAVmin[(16.59 ± 1.35) mL]and LAVp[(26.56 ± 3.56) mL] as well as decreased LAAEF(37.82 % ± 5.77 %)(P < 0.05) were found in group B. Compared with group C, SRa of 12 segments in group A was significantly higher than that in group C(P < 0.05);Compared with group A and group C, the SRa of 12 segments in group B was lower than that in group A and group C(P < 0.05). Conclusion It is demonstrated that VVI technology is more sensitive than conventional ultrasound in displaying the changes of left atrial function, and could accurately assess the changes of left atrial systolic function in patients with SLE.