CAJ | 학술논문

目的探讨高频超声结合E-flow显像评价系统性硬化病(systemic sclerosis,SSc)患者指端微循环病变的临床价值.方法 SSc患者 24 例,正常对照组 29 例,均行高频超声检查并结合E-flow显像,观察各组受试者左右手中指末节指端血管分布特征、走行,测量指掌侧固有动脉、指腹动脉及甲床动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)、平均血流速度(MV)、阻力指数(RI)及搏动指数(PI).结果对照组末节指端血流信号丰富,可清晰显示指掌侧固有动脉、指腹动脉、甲床动脉及其细小分支;SSc末节指端血流显示欠清晰,连续性欠佳,血流分布明显减少.与对照组相比,SSc组中指末端指掌侧固有动脉、指腹动脉及甲床动脉PSV、EDV、MV均减低(P＜0.01),而RI及PI增高(P＜0.05).对照组左右侧指端动脉血流参数无明显差异(P＞0.05),而SSc组左侧指掌侧固有动脉PSV、EDV及MV指标较右侧增高,差异均有统计学意义(P＜0.05).结论高频超声结合E-flow显像可敏感、准确地反映SSc患者的指端微循环变化,为临床评价SSc患者微血管病变情况提供了新方法.
목적 탐토고빈초성결합E-flow현상평개계통성경화병(systemic sclerosis,SSc)환자지단미순배병변적림상개치.방법 SSc환자 24 례,정상대조조 29 례,균행고빈초성검사병결합E-flow현상,관찰각조수시자좌우수중지말절지단혈관분포특정、주행,측량지장측고유동맥、지복동맥급갑상동맥수축기봉치류속(PSV)、서장말기류속(EDV)、평균혈류속도(MV)、조력지수(RI)급박동지수(PI).결과 대조조말절지단혈류신호봉부,가청석현시지장측고유동맥、지복동맥、갑상동맥급기세소분지;SSc말절지단혈류현시흠청석,련속성흠가,혈류분포명현감소.여대조조상비,SSc조중지말단지장측고유동맥、지복동맥급갑상동맥PSV、EDV、MV균감저(P＜0.01),이RI급PI증고(P＜0.05).대조조좌우측지단동맥혈류삼수무명현차이(P＞0.05),이SSc조좌측지장측고유동맥PSV、EDV급MV지표교우측증고,차이균유통계학의의(P＜0.05).결론 고빈초성결합E-flow현상가민감、준학지반영SSc환자적지단미순배변화,위림상평개SSc환자미혈관병변정황제공료신방법.
Objective To investigate the clinical value of high frequency ultrasonography with E-flow imaging in the evaluation of fingertip's microcirculation changes in patients with systemic sclerosis(SSc).Methods Twenty-four SSc patients and 29 healthy subjects were involved.High frequency ultrasonography with E-flow imaging was used to observe the configuration and distribution of digital arteries in the last segment of left and right middle finger.Peak systolic velocity (PSV),end diastolic velocity (EDV),mean velocity(MV),vascular resistance index (RI) and pulsatility index(PI) of digital palmar propria arteries,nail bed arteries and finger ventral arteries were measured.Results In control group,rich blood supply was revealed within the fingertips.Digital palmar propria arteries,nail bed arteries and finger ventral arteries and their small branches were displayed clearly and continuously by E-flow imaging.While in SSc patients,the definition and continuity of fingertip's small vascular flow images were not as good as that in the control group,with the distribution of blood flow markedly reduced.compared with the control group,PSV,EDV and MV of digital palmar propria arteries,nail bed arteries,finger ventral arteries were decreased in SSc group(P＜0.01),but both RI and PI were increased(P＜0.05).There were no statistically significant differences between left and right fingertip's arteries index in normal control group (P＞0.05).But PSV,EDV and MV of left digital palmar propria arteries in SSc group were higher than that of the right(P＜0.05),whose differences bear statistic significance.Conclusions High frequency ultrasonography with E-flow imaging is sensitive and reliable to reflect fingertip's microcirculation changes and provide a new method to assess microvascular changes in SSc patients.