二维斑点追踪成像评价系统性红斑狼疮病程早期右心室同步性

Two-dimensional speckle tracking imaging for evaluation right ventricular synchrony of early stage systemic lupus erythematosus

目的观察二维斑点追踪成像(2D-STI)评价系统性红斑狼疮(SLE)病程早期右心室(RV)同步性的价值。方法回顾性分析接受心脏超声检查的60例SLE(SLE组)及65名健康体检者(对照组),比较组间一般资料、常规超声参数,以及2D-STI所测超声应变参数及同步性参数的差异;采用Pearson相关分析观察SLE组内一般资料、常规超声参数及应变参数与RV同步性参数的相关性,以多元线性回归分析筛选SLE病程早期RV同步性的独立影响因素。结果组间一般资料及常规超声参数差异均无统计学意义(P均>0.05)。SLE组应变参数均低于、同步性参数均高于对照组(P均<0.05)。SLE组RV同步性参数[RV整体SD-TPS(SD-TPS_(global))、游离壁SD-TPS(SD-TPS_(free))、室间隔SD-TPS(SD-TPS_(septal))应变达峰时间标准差]与病程及SLE疾病活动指数(SLEDAI)均呈弱正相关(│r│为0.256~0.273,P均<0.05),与RV整体纵向应变(GLS)均呈低度负相关(│r│为0.435~0.488,P均<0.05)。RV GLS为SLE病程早期RV同步性的独立影响因素(P均<0.05)。结论利用2D-STI测算RV GLS可观察SLE早期RV同步性。

Objective To observe the value of two-dimensional speckle tracking imaging(2D-STI)for evaluating right ventricular(RV)synchrony of early stage systemic lupus erythematosus(SLE).Methods Totally 60 SLE patients(SLE group)and 65 healthy subjects(control group)who underwent echocardiography were retrospectively enrolled.The general data,conventional ultrasonic parameters,strain parameters based on 2D-STI and synchrony parameters based on 2D-STI were compared between groups.Pearson correlation analysis was performed to explore the correlations of general information,conventional ultrasonic parameters and strain parameters with synchrony parameters in SLE group.Multiple linear regression was used to analyze the independent impact factors of RV synchrony of early stage SLE.Results No significant difference of general data nor conventional ultrasound parameters was found between groups(all P>0.05).Strain parameters in SLE group were all lower,whereas synchrony parameters in SLE group were all higher than those in control group(all P<0.05).In SLE group,synchrony parameters of RV(standard deviation of time to peak strain of global[SD-TPS global],of free wall[SD-TPS_(free)]and of interventricular septum[SD-TPS_(septal)])were positively and weakly correlated with both SLE duration and systemic lupus erythematosus disease activity index(SLEDAI)(│r│0.256—0.273,all P<0.05),but slightly and negatively correlated with global longitudinal strain(GLS)of RV(│r│0.435—0.488,all P<0.05).GLS of RV was the independent impact factor of synchrony parameters of early stage SLE(P<0.05).Conclusion 2D-STI could be used to evaluate synchrony of RV in early stage SLE through measuring GLS of RV.