三维斑点追踪成像对系统性红斑狼疮患者左心室整体收缩功能变化的应用观察
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摘要
目的探究三维斑点追踪成像技术(3-dimensional speckle tracking imasing, 3D-STI)对系统性红斑狼疮(systemic lupus erythematosus, SLE)患者左心室整体收缩功能变化的应用价值。方法将我院2016年9月—2018年1月确诊为SLE的63例作为观察组,并选取同期来我院体检的63例健康志愿者作为对照组。对两组进行常规超声心动图及3D-STI检查,观察并比较两组左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVEDs)、室间隔舒张末期厚度(IVSd)、左心室后壁舒张末期厚度(LVPWd)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左室射血分数(LVEF)常规超声心动图指标,以及左心室收缩期整体纵向应变(GLS)、整体圆周应变(GCS)、整体径向应变(GRS)、整体面积应变(GAS)3D-STI参数。结果两组LVEDd、LVEDs、IVSd、LVPWd、LVEDV、LVESV、LVEF比较差异均无统计学意义(P>0.05);观察组GLS、GCS、GRS、GAS值均低于对照组,差异均有统计学意义(P<0.01)。结论 3D-STI可以对SLE患者左心室整体收缩功能进行检测,为临床监测患者心脏收缩功能变化提供依据。
Objective To explore the application value of 3-dimensional speckle tracking imaging(3 D-STI) in the changes of global left ventricular systolic function in patients with systemic lupus erythematosus(SLE). Methods Sixty-three patients diagnosed with SLE in our hospital from September 2016 to January 2018 were enrolled as the observation group, and 63 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. All patients underwent routine echocardiography and 3 D-STI examination. The left ventricular end-diastolic diameter(LVEDd), left ventricular end-systolic diameter(LVEDs), interventricular septal depth(IVSd), left ventricular posterior wall end-diastolic thickness(LVPWd), left ventricular end-diastolic volume(LVEDV), left ventricular end-systolic volume(LVESV), left ventricular ejection fraction(LVEF), left ventricular systolic global longitudinal strain(GLS), global circumferential strain(GCS), global radial strain(GRS), and global area strain(GAS) were observed and compared using 3 D-STI.Results There were no significant differences in LVEDd, LVEDs, IVSd, LVPWd, LVEDV, LVESV and LVEF between the two groups(P>0.05). The GLS, GCS, GRS and GAS in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.01). Conclusion 3 D-STI can detect changes of global systolic function of left ventricle in patients with SLE, and provide a basis for clinical monitoring of cardiac systolic function.
Objective To explore the application value of 3-dimensional speckle tracking imaging(3 D-STI) in the changes of global left ventricular systolic function in patients with systemic lupus erythematosus(SLE). Methods Sixty-three patients diagnosed with SLE in our hospital from September 2016 to January 2018 were enrolled as the observation group, and 63 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. All patients underwent routine echocardiography and 3 D-STI examination. The left ventricular end-diastolic diameter(LVEDd), left ventricular end-systolic diameter(LVEDs), interventricular septal depth(IVSd), left ventricular posterior wall end-diastolic thickness(LVPWd), left ventricular end-diastolic volume(LVEDV), left ventricular end-systolic volume(LVESV), left ventricular ejection fraction(LVEF), left ventricular systolic global longitudinal strain(GLS), global circumferential strain(GCS), global radial strain(GRS), and global area strain(GAS) were observed and compared using 3 D-STI.Results There were no significant differences in LVEDd, LVEDs, IVSd, LVPWd, LVEDV, LVESV and LVEF between the two groups(P>0.05). The GLS, GCS, GRS and GAS in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.01). Conclusion 3 D-STI can detect changes of global systolic function of left ventricle in patients with SLE, and provide a basis for clinical monitoring of cardiac systolic function.
引文
[1] 张瑞芳,刘海艳,赵丽娟,等.超声三维斑点追踪成像评价系统性红斑狼疮左心室整体收缩功能[J].中国医学影像技术,2016,32(2):254-257.
[2] 高帅,孙志丹,徐静,等.三维斑点追踪成像评价轻型系统性红斑狼疮患者左心室收缩功能[J].中国医学影像学杂志,2016,24(1):16-18,23.
[3] 刘娜娜,张禄桐,任敏,等.三维斑点追踪成像评价系统性红斑狼疮患者左室局部心肌应变[J].临床超声医学杂志,2016,18(4):221-224.
[4] 何艳洁,王志刚,杨扬.二维斑点追踪成像技术评价未合并肺动脉高压的系统性红斑狼疮患者早期右室收缩功能改变的研究[J].临床超声医学杂志,2016,18(6):371-374.
[5] 王健,王医林,吉健华,等.羟氯喹对系统性红斑狼疮患者血脂及心功能影响的观察[J].人民军医,2016,59(3):262-263.
[6] 曹白羽.实时三维超声心动图对系统性红斑狼疮合并肺动脉高压患者右心功能评价[J].中国医疗设备,2017,32(4):74-78.
[7] 葛晓颖,邵璐,郑哲岚.实时三维超声和斑点追踪技术早期评价系统性红斑狼疮患者右心房功能[J].中华医学杂志,2016,96(47):3815-3818.
[8] 张帆,马丽,贺立群,等.尼可地尔联合阿托伐他汀治疗合并心脏损害的系统性红斑狼疮患者的疗效[J].临床和实验医学杂志,2017,16(3):260-263.
[9] Leal G N, Silva K F, Lianza A C, et al. Subclinical left ventricular dysfunction in childhood-onset systemic lupus erythematosus: a two-dimensional speckle-tracking echocardiographic study[J].Scand J Rheumatol, 2016,45(3):202-209.
[10] 茅魁,黄向阳.实时三维超声心动图联合Tei指数评价SLE患者右心功能临床价值[J].皖南医学院学报,2017,36(4):381-384.
[11] 张贺彬,郑哲岚,高枫,等.超声二维斑点追踪显像技术评价系统性红斑狼疮患者左心室收缩功能的应用[J].浙江医学,2015,37(20):1681-1684,1695.
[12] 陈娜,郑慧,周旺,等.三维斑点追踪成像及左心室整体心肌应变评价化疗对肺癌患者的心脏毒性[J].安徽医科大学学报,2016,51(11):1638-1642.
[13] Kim K J, Baek I W, Yoon C H, et al. Association of Anemic Hypoxia and Increased Pulmonary Artery Systolic Pressure in Patients With Systemic Lupus Erythematosus[J].Arthritis Care Res (Hoboken), 2016,67(12):1702-1711.
[14] 张禄桐,田永梅,李海茹,等.三维斑点追踪技术评价系统性红斑狼疮患者左心室整体和局部收缩功能[J].中华超声影像学杂志,2015,15(6):472-475.
[15] 周红丽,张棣,郭盛兰,等.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的应用价值[J].广西医学,2013,35(6):725-726,729.
[2] 高帅,孙志丹,徐静,等.三维斑点追踪成像评价轻型系统性红斑狼疮患者左心室收缩功能[J].中国医学影像学杂志,2016,24(1):16-18,23.
[3] 刘娜娜,张禄桐,任敏,等.三维斑点追踪成像评价系统性红斑狼疮患者左室局部心肌应变[J].临床超声医学杂志,2016,18(4):221-224.
[4] 何艳洁,王志刚,杨扬.二维斑点追踪成像技术评价未合并肺动脉高压的系统性红斑狼疮患者早期右室收缩功能改变的研究[J].临床超声医学杂志,2016,18(6):371-374.
[5] 王健,王医林,吉健华,等.羟氯喹对系统性红斑狼疮患者血脂及心功能影响的观察[J].人民军医,2016,59(3):262-263.
[6] 曹白羽.实时三维超声心动图对系统性红斑狼疮合并肺动脉高压患者右心功能评价[J].中国医疗设备,2017,32(4):74-78.
[7] 葛晓颖,邵璐,郑哲岚.实时三维超声和斑点追踪技术早期评价系统性红斑狼疮患者右心房功能[J].中华医学杂志,2016,96(47):3815-3818.
[8] 张帆,马丽,贺立群,等.尼可地尔联合阿托伐他汀治疗合并心脏损害的系统性红斑狼疮患者的疗效[J].临床和实验医学杂志,2017,16(3):260-263.
[9] Leal G N, Silva K F, Lianza A C, et al. Subclinical left ventricular dysfunction in childhood-onset systemic lupus erythematosus: a two-dimensional speckle-tracking echocardiographic study[J].Scand J Rheumatol, 2016,45(3):202-209.
[10] 茅魁,黄向阳.实时三维超声心动图联合Tei指数评价SLE患者右心功能临床价值[J].皖南医学院学报,2017,36(4):381-384.
[11] 张贺彬,郑哲岚,高枫,等.超声二维斑点追踪显像技术评价系统性红斑狼疮患者左心室收缩功能的应用[J].浙江医学,2015,37(20):1681-1684,1695.
[12] 陈娜,郑慧,周旺,等.三维斑点追踪成像及左心室整体心肌应变评价化疗对肺癌患者的心脏毒性[J].安徽医科大学学报,2016,51(11):1638-1642.
[13] Kim K J, Baek I W, Yoon C H, et al. Association of Anemic Hypoxia and Increased Pulmonary Artery Systolic Pressure in Patients With Systemic Lupus Erythematosus[J].Arthritis Care Res (Hoboken), 2016,67(12):1702-1711.
[14] 张禄桐,田永梅,李海茹,等.三维斑点追踪技术评价系统性红斑狼疮患者左心室整体和局部收缩功能[J].中华超声影像学杂志,2015,15(6):472-475.
[15] 周红丽,张棣,郭盛兰,等.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的应用价值[J].广西医学,2013,35(6):725-726,729.