定量组织速度成像评价系统性红斑狼疮患者左心室功能的价值

目的探讨应用定量组织速度成像（quantitative tissue velocity imaging,QTVI）技术评价系统性红斑狼疮（systemic lupus erythematosus,SLE）患者左心室收缩与舒张功能损害的价值。方法 40例绝经期前女性SLE患者,其中SLE病程〈5a者18例为SLEⅠ组,病程≥5a者22例为SLEⅡ组,同期体检健康者20例为对照组,3组行常规超声心动图检查后,应用QTVI技术检测二尖瓣环水平前壁、下壁、后间隔、侧壁、前间隔、后壁的收缩期峰值运动速度（systolic peak velocity,Vs）、舒张早期峰值运动速度（early diastolic peak velocity,Ve）、舒张晚期峰值运动速度（late diastolic peak velocity,Va）,并计算Ve/Va比值,以6个位点均值代表二尖瓣环的整体运动,并进行比较。结果 SLEⅠ组左心室二尖瓣环水平各壁Vs、Va及其均值与对照组比较差异均无统计学意义（P〉0.05）,各壁Ve、Ve/Va及其均值均较对照组降低（P〈0.05或〈0.01）;SLEⅡ组左心室二尖瓣环水平各壁Vs、Ve、Ve/Va及其均值均较对照组降低（P〈0.05或〈0.01）,除侧壁外,余各壁Va均较对照组降低（P〈0.05或〈0.01）;与SLEⅠ组比较,SLEⅡ组左心室二尖瓣环水平侧壁Vs及各壁Vs均值均降低（P〈0.05或〈0.01）,各壁Ve、Ve/Va及其均值均降低（P〈0.05或〈0.01）,前间隔Va降低（P〈0.05）;SLE患者Vs、Ve、Va、Ve/Va均与病程呈负相关（r=-0.637,P=0.000;r=-0.700,P=0.000;r=-0.367,P=0.020;r=-0.779,P=0.000）。结论应用QTVI技术可早期、敏感检测出SLE患者左心室功能异常,对临床早期防治心脏并发症有指导意义。

Value of quantitative tissue velocity imaging to the assessment of left ventricular functions in patients with systemic lupus erythematosus

Objective To explore the value of quantitative tissue velocity imaging（QTVI）to the assess went of left ventricular systolic and diastolic functions in patients with systemic lupus erythematosus.Methods Forty female patients before menopause with SLE were divided into two groups according to different courses of disease：SLE groupⅠ（〈5years,n=18）and SLE groupⅡ（≥5years,n=22）.And another 20 healthy volunteers were served as control group.After echocardiography,QTVI technique was applied to measure the systolic peak velocity（Vs）,early diastolic peak velocity（Ve）and end diastolic peak velocity（Va）at the mitral annular leval of the anteroseptal,posterior,septal,lateral,anterior and inferior walls,and Ve/Va ratio was calculated and compared.The mean value of the velocities represented the mitral annular global movement.Results There were no significant differences in Vs and Va of all walls at the mitral annular level,and their mean values between SLE groupⅠ and control group（P〉0.05）,and Ve,Ve/Va ratio of all walls and the mean value were significantly lower in SLEⅠ group than those in control group（P〈0.05,P〈0.01）.Vs,Ve,Ve/Va and their mean values of all walls at the mitral annular level,and Va of all walls except lateral wall were lower in SLE group Ⅱ than those in control group（P〈0.05,P〈0.01）.Vs of lateral wall at the mitral annular level and the Vs mean values of all walls,Vs and Ve/Va and their mean values of all walls,and Va of anterior wall were lower in SLE group Ⅱ than those in SLE group Ⅰ（P〈0.05,P〈0.01）.Vs,Ve,Va and Ve/Va were negatively correlated with the courses of disease of SLE（r=-0.637,P=0.000;r=-0.700,P=0.000;r=-0.367,P=0.020;r=-0.779,P=0.000）.Conclusion QTVI technique can detect abnormal left ventricular function early and sensitively,which helps preventing the cardiac complication in the early stage.