| 摘要: |
| 目的 运用全自动三维超声右心室定量软件（3D Auto RV）评估系统性红斑狼疮（SLE）患者的右室收缩功能，并分析其与红细胞分布宽度（RDW）的相关性。方法 回顾性分析2022年9月至2023年7月在我院风湿免疫科诊断为SLE的70例患者的诊疗资料，根据超声心动图测得的肺动脉收缩压（PASP）将患者分为3组，B组PASP≤30mmHg，C组30mmHg＜PASP＜50mmHg，D组PASP≥50mmHg。另选择同期性别比例及年龄等相匹配的健康对照者25例为A组，全部完成超声心动图检查及血常规检测。记录所有研究对象的性别、年龄、体质量指数（BMI）、体表面积，二维超声心动图获取左室射血分数（LVEF）、右室面积变化率（FAC）、三尖瓣环收缩期平面位移（TAPSE）、三尖瓣环收缩期峰值速度（S′）。3D Auto RV获得右室舒张末期容积指数（EDVi）、收缩末期容积指数（ESVi）、右室每搏量（RVSV）、右室射血分数（RVEF）、右室游离壁纵向应变（FWLS）、室间隔纵向应变（SLS）。应用单因素方差分析进行多组间比较，通过spearman相关性分析评估RDW与右室收缩功能参数之间的相关性，应用多元线性回归分析影响右室收缩功能的因素。结果 与A、B、C三组相比，D组的RVFAC明显减小，EDVi、ESVi明显增大，与A、B两组相比，C、D两组RVEF、FWLS明显减小，与B组相比，C、D两组SLS明显减小，B、C、D三组RDW水平均高于A组，差异均有统计学意义（P<0.05）。spearman相关性分析显示RDW与EDVi、ESVi呈正相关（r=0.211、0.251，P<0.05），与RVEF、FWLS、SLS呈负相关（r=-0.284、-0.247、-0.251，P<0.05）。多元线性回归分析显示RDW（β=-0.704，P=0.042）、PASP（β=-0.190，P<0.001）为RVEF的独立影响因子。结论 3D Auto RV能够检测出SLE患者早期右室收缩功能受损的情况。RDW与右心室收缩功能呈负相关，RDW及PASP升高是右室收缩功能降低的独立影响因素。 |
| 关键词: 右室收缩功能 全自动三维超声右心室定量 系统性红斑狼疮 红细胞分布宽度 |
| DOI： |
| 投稿时间：2023-12-04修订日期：2024-02-14 |
| 基金项目: |
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| Evaluation of right ventricular systolic function based on 3D Auto RV and its correlation with red blood cell distribution width in patients with systemic lupus erythematosus |
| HOU Rong,SHI yujing,XU jianping |
| (Shanxi Medical University;First Hospital of Shanxi Medical University) |
| Abstract: |
| Objective: This study aims to assess the right ventricular systolic function in patients with systemic lupus erythematosus (SLE) using fully automated right ventricular quantification software with 3D echocardiography (3D Auto RV) and to examine the correlation between right ventricular systolic function and red blood cell distribution width (RDW). Methods: We retrospectively analyzed the clinical data of 70 patients diagnosed with SLE in the Department of Rheumatic Immunology at our hospital from September 2022 to July 2023. Patients were categorized into three groups based on pulmonary artery systolic pressure (PASP): group B (PASP ≤ 30mmHg), group C (30mmHg < PASP < 50mmHg), and group D (PASP ≥ 50mmHg). Additionally, 25 healthy controls matched for sex and age during the same period were selected as group A. All subjects underwent echocardiography and blood routine examination. Demographic variables including sex, age, body mass index (BMI), and body surface area (BSA) were recorded. Two-dimensional echocardiography provided measurements of left ventricle ejection fraction (LVEF), tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic peak velocity (S'), and right ventricular area change rate (RVFAC). Measurements obtained by 3D Auto RV software included right ventricular end-diastolic volume index (EDVi), right ventricular end-systolic volume index (ESVi), right ventricular stroke volume (RVSV), right ventricular ejection fraction (RVEF), longitudinal strain of the right ventricular free wall (FWLS), and longitudinal strain of the interventricular septum (SLS). One-way ANOVA was used for intergroup comparisons. Spearman correlation analysis assessed the relationship between RDW and right ventricular systolic function parameters. Multiple linear regression was performed to analyze the influencing factors of right ventricular systolic function. Results: Compared to group A, both groups B and C showed significantly decreased RVFAC in group D, with significantly increased EDVi and ESVi. RVEF and FWLS were significantly decreased in groups C and D compared to groups A and B. Additionally, SLS was significantly decreased in groups C and D compared to group B. RDW levels were significantly higher in groups B, C, and D compared to group A (all P < 0.05). Spearman correlation analysis revealed positive correlations between RDW and EDVi as well as ESVi (r = 0.211, 0.251, all P < 0.05), and negative correlations with RVEF, FWLS, and SLS (r = -0.284, -0.247, -0.251, all P < 0.05). Multiple linear regression analysis identified RDW (β =-0.704, P=0.042) and PASP (β =-0.190, P=0.000) as independent influencing factors of RVEF. Conclusion: 3D Auto RV facilitates early detection of right ventricular systolic function impairment in SLE patients. There exists a negative correlation between RDW and right ventricular systolic function, with increased RDW and PASP serving as independent influencing factors for decreased right ventricular systolic function. |
| Key words: right ventricular systolic function fully automated right ventricular quantification software with 3D echocardiography systemic lupus erythematosus red blood cell distribution width |
