| 摘要: |
| 目的 探讨应用二维斑点追踪技术（2D-STI）及实时三维超声心动图（RT-3DE）评估系统性硬化症患者的左心室亚临床心肌受累。方法 选取我院确诊为系统性硬化症且无明显结构性心脏病及肺动脉高压的33例患者为病例组，其中抗Scl-70抗体和（或）抗Ro52抗体阳性者16例，抗体阴性者17例。另纳入同一时间段33例健康志愿者为正常对照组。收集两组的临床及实验室资料，同时应用常规超声心动图、二维斑点追踪技术及实时三维超声心动图检查获取超声参数，比较各组上述各参数间的差异。结果 与对照组相比，病例组的整体纵向应变参数减低，18节段牛眼图中的16个节段应变参数差异具有统计学意义（P均＜0.05），其中以基底段和中间段为主。病例组的整体周向应变参数与对照组相比减低不明显，差异无统计学意义（P＞0.05）。病例组的LVEDV、3D-LVEF低于对照组（P＜0.05），同步性参数（Tmsv-16-SD、Tmsv-16-Dif、Tmsv-16-SD%及Tmsv-16-Dif%）与对照组相比均延长（P＜0.05），且病例组左室收缩同步性参数均与 3D-EF 呈显著负相关。结论 临床无明显心血管症状及射血分数保留的系统性硬化症患者中，其左室整体纵向应变能力及左室壁心肌运动同步性均已降低，2D-STI及RT-3DE有助于早期发现SSc的左心室亚临床心肌受累情况，为临床早期诊断、早期治疗及疗效评估提供新的依据。 |
| 关键词: 斑点追踪,二维 实时,三维 超声心动描记术 左心室 系统性硬化症 |
| DOI： |
| 投稿时间：2024-05-30修订日期：2024-07-17 |
| 基金项目: |
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| Evaluation of subclinical myocardial involvement of the left ventricle in patients with systemic sclerosis by 2D-STI and RT-3DE |
| xuhuining,guotai,lufang |
| (Shanxi Medical University) |
| Abstract: |
| Objective To explore the left ventricular subclinical myocardial involvement in patients with systemic sclerosis by two-dimensional speckle tracking imaging (2D-STI) and real-time three-dimensional echocardiography (RT-3DE). Method Thirty-three patients diagnosed with systemic sclerosis without obvious structural heart disease and pulmonary hypertension in our hospital were selected as the study group, including 16 patients with positive anti-Scl-70 antibody or anti-Ro52 antibody, and 17 patients with negative antibodies. Another 33 healthy volunteers at the same time were selected as the control group. The clinical and laboratory data of the two groups were collected, the ultrasonic parameters were obtained by conventional echocardiography, two-dimensional speckle tracking imaging and real-time three-dimensional echocardiography. The differences of the above parameters in each group were compared. Results Compared with the control group, the global longitudinal strain parameters of the study group were reduced, and the differences in strain parameters of the 16 segments in the 18-segment bull 's eye diagram were statistically significant (P < 0.05), mainly in the basal and middle segments. There was no significant difference in the global circumferential strain parameters between the study group and the control group (P > 0.05). The LVEDV and 3D-LVEF in the study group were lower than those in the control group (P < 0.05), and the synchrony parameters (Tmsv-16-SD, Tmsv-16-Dif, Tmsv-16-SD%, and Tmsv-16-Dif%) were longer than those in the control group (P < 0.05). Left ventricular systolic synchrony parameters were significantly negatively correlated with 3D-EF. Conclusions In SSc without obvious cardiovascular symptoms with preserved ejection fraction, the left ventricular global longitudinal strain capacity and left ventricular wall myocardial motion synchrony have been reduced, 2D-STI and RT-3DE are helpful for early detection of left ventricular subclinical myocardial involvement in SSc, and provide a new basis for early clinical diagnosis, early treatment and efficacy evaluation. |
| Key words: Speckle tracking,two-dimensional Real-time, three- dimensional Echocardiography Left ventricular Systemic sclerosis |
