| 林薿,李春梅,尹立雪,邓燕,李文华,方杰.实时三维超声心动图评价系统性红斑狼疮并发肺动脉高压患者右心功能[J].中国医学影像技术,2015,31(9):1331~1335 |
| 实时三维超声心动图评价系统性红斑狼疮并发肺动脉高压患者右心功能 |
| Real-time three-dimensional echocardiography for evaluation of right ventricular function in systemic lupus erythematosus patients with pulmonary hypertension |
| 投稿时间：2014-12-08 修订日期：2015-06-04 |
| DOI：10.13929/j.1003-3289.2015.09.012 |
| 中文关键词: 系统性红斑狼疮 超声心动描记术,三维 心脏功能,右 肺动脉高压 |
| 英文关键词:Systemic lupus erythematosus Echocardiography, three-dimensional Heart function, right Pulmonary arterial hypertension |
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| 中文摘要: |
| 目的 采用实时三维超声心动图(RT-3DE)和传统二维超声心动图综合评价系统性红斑狼疮(SLE)并发肺动脉高压(PAH)患者右心结构和功能.方法 获得60例SLE患者(无PAH亚组、轻度PAH亚组、中重度PAH亚组)和28名健康对照者(对照组)右心常规超声和三维全容积超声动态图像,测量常规右心结构、功能和血流动力学参数;采用三维分析软件获得右心室舒张末期容积指数(RVEDVI-3D)和收缩末期容积指数(RVESVI-3D),射血量(RVSV-3D)、射血分数(RVEF-3D),比较其在各组间的差异,分析各参数间的相关性.结果 中重度PAH亚组RA长短轴内径、RV乳头肌部和基底部内径明显增大,RVEDVI-2D和RVESVI-2D明显增大,RVEF-2D明显降低,差异均有统计学意义(P均 <0.05);不同组间RVFAC、RVTei指数、RV e/a差异均有统计学意义(P均 <0.05);中重度PAH亚组TAPSE、s明显降低,E/e明显增大,差异均有统计学意义(P均 <0.05).中重度PAH亚组RVEDVI-3D和RVESVI-3D明显增大,RVEF-3D和RVSV-3D明显降低,差异均有统计学意义(P均 <0.05).三尖瓣环收缩期位移(TAPSE)、s、RVFAC分别与肺动脉收缩压呈负相关(P均 <0.001).RV Tei指数分别与PVR、肺动脉收缩压、平均压呈正相关(P均 <0.001).RVEDVI-3D、RVESVI-3D分别与PVR、肺动脉收缩压、平均压呈正相关(P均 <0.05).RVEF-3D与s、TAPSE分别呈正相关(P均 <0.001).RVEDVI-3D、RVESVI-3D分别与RVTei指数呈正相关(P均 <0.001).RVEDVI-3D、RVESVI-3D分别与s呈负相关(P均 <0.05).结论 RT-3DE可在机、快速、定量分析SLE患者RV容积和功能,适于临床应用. |
| 英文摘要: |
| Objective To evaluate right ventricular (RV) regional and global structural and functional abnormalities in patients with systemic lupus erythematosus (SLE) complicated with pulmonary arterial hypertension (PAH), and to analyze the relationship between echocardiographic parameters using the real-time three-dimensional echocardiography (RT-3DE) and routine echocardiography. Methods Sixty patients with SLE (without PAH subgroup, mild PAH subgroup, moderate to severe PAH subgroup) and twenty-eight healthy control subjects (control group) were included. Standard echocardiography was performed. RT-3DE with full-volume imaging was acquired for RV end diastolic volume (RVEDVI-3D), end systolic volume (RVESVI-3D) and ejection fraction (RVEF-3D). All data was compared using analysis of variance with post hoc correlation. Simple linear regression analysis was used for comparison of conventional echocardiographic parameters, RT-3DE RV volume and RVEF, and RV hemodynamic variables including pulmonary arterial systolic pressure (PASP), pulmonary vascular resistance (PVR). Results RV outflow tract diameter in patients with PAH was significantly larger than that in control group (all P <0.05). Right atria and RV was significantly larger in moderate to severe PAH subgroup than that in other groups (all P <0.05). The s, e/a, RVFAC significantly reduced, RV Tei index significantly higher in SLE patients than that in control group (all P <0.05). RVEDVI-3D, RVESVI-3D and RVEF-3D reduced obviously in moderate to severe PAH subgroup compared with other groups (all P <0.05). Regression analysis revealed a significant correlation between tricuspid annular plane systolic excursion (TAPSE), s, RVFAC, RVTei with PASP (all P <0.001). RVEF-3D had a positive correlation with TAPSE (P <0.001). PASP, PVR, RVTei and s had a weak relationship with RVEDVI-3D and RVESVI-3D (P <0.001). Conclusion RT-3DE can be used to quantitatively, easily and accurately assess RV entire systolic function in patients with SLE. |
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