系统性红斑狼疮患儿左心功能的组织应变成像技术评价

目的 探讨组织应变成像技术在评价系统性红斑狼疮(SLE)患儿左心功能的临床应用价值.方法 42例正常儿童与30例SLE患儿均接受常规超声及组织多普勒检测,获取二尖瓣血流E/A值、左室短轴缩短率(left ventricular fractional shortening,LVFS)、射血分数(left ventricular ejectionfraction,LVEF)及左室心肌的收缩期及舒张期峰值应变和应变率.结果①SLE组患儿的E/A值、LVFS及LVEF分别为(1.46±0.57)、(37.3±3.8)%、(65.2±6.3)%;正常对照组儿童的E/A值、LVFS及LVEF分别为(1.61±0.54)、(39.2±4.5)%、(67.0±5.6)%.以上3组数据分别比较,两组儿童之间的差异均无统计学意义(P＞0.05);SLE组患儿心肌的收缩期应变、应变率峰值低于正常对照组,但差异无统计学意义(P＞0.05).②SLE组患儿舒张期应变率峰值低于正常对照组(P＜0.01).③SLE组患儿中抗心磷脂抗体(anticardiolipin antibodies,aCL)阳性者心肌舒张期应变率峰值低于aCL阴性者(P＜0.05).结论 应变及应变率和aCL结合可以较敏感检测SLE儿童左心功能的早期损害.

Evaluation of tissue strain and strain rate imaging for left heart function in children with systemic lupus erythematosus

Objective To investigate the diagnostic value of the tissue strain imaging in myocardialdysfunction in children with systemic lupus erythematosus (SLE). Methods 24 patients with SLE and 32healthy controls underwent conventional and tissue Doppler echocardiography. Peak strain and strain ratevalue during systolic and diastolic phases as well as E/A, LVFS, LVEF were measured in both SLE and thecontrol group subjects. Results The E/A, LVFS and LVEF did not significantly differ between SLEchildren and controls (P＞0. 05). The systolic peak strains and strain rates of SLE children were lower thanthose of the controls but there was no significant difference ( P＞0. 05 ). The diastolic peak strains and strainrates of SLE children were significantly lower than those of the controls ( P＜0. 01 ). The diastolic peakstrains and strain rates of anticardiolipin antibodies (aCL) positive children were significantly lower than theaCL negtive ones (P＜0. 05 ). Conclusion Strain and strain rate combined with aCL could sensitivelydetect myocardial dysfunction of children with SLE.