CAJ | 학술논문

目的：研究强直性脊柱炎患者心功能变化及与其他指标的相关性。方法：采用超声心动图（UCG）检测强直性脊柱炎140例患者心功能变化，并与正常对照组30例进行比较，观察强直性脊柱炎患者临床症状、体征及实验室指标与心功能参数相关情况，以探讨其作用机制。结果：①强直性脊柱炎组UCG心功能变化检测结果异常率为33.56%，正常对照组异常率为9.99%，两组比较，差异有统计学意义（P<0.01）。②强直性脊柱炎患者舒张晚期血流峰值（A峰）显著升高（P<0.01）；舒张早期血流峰值（E峰）、射血分数、E/A比值显著降低（P<0.01）。③Spearman相关分析结果显示，强直性脊柱炎组患者心功能参数E峰与白细胞介素-10，A峰与心悸均呈显著正相关（P<0.05或P<0.01）。E峰与病程、食欲减退、少气懒言、食后腹胀、大便稀溏、血小板计数、尿酸、免疫球蛋白G、红细胞沉降率、C-反应蛋白，E/A比值与病程、食欲减退、少气懒言、食后腹胀、大便稀溏、a-酸性糖蛋白、白细胞介素-17，射血分数与病程、心悸、倦怠乏力、食后腹胀、C3，FS,%与少气懒言、三酰甘油均呈显著负相关（P<0.05或P<0.01）。结论：强直性脊柱炎患者存在心功能下降，表现为A峰升高，E峰、射血分数、E/A比值降低，且与症状体征积分、实验室指标相关。强直性脊柱炎患者心功能下降的机制可能是由于其体内免疫功能紊乱及细胞因子失衡引起心肌受损导致。
목적：연구강직성척주염환자심공능변화급여기타지표적상관성。방법：채용초성심동도（UCG）검측강직성척주염140례환자심공능변화，병여정상대조조30례진행비교，관찰강직성척주염환자림상증상、체정급실험실지표여심공능삼수상관정황，이탐토기작용궤제。결과：①강직성척주염조UCG심공능변화검측결과이상솔위33.56%，정상대조조이상솔위9.99%，량조비교，차이유통계학의의（P<0.01）。②강직성척주염환자서장만기혈류봉치（A봉）현저승고（P<0.01）；서장조기혈류봉치（E봉）、사혈분수、E/A비치현저강저（P<0.01）。③Spearman상관분석결과현시，강직성척주염조환자심공능삼수E봉여백세포개소-10，A봉여심계균정현저정상관（P<0.05혹P<0.01）。E봉여병정、식욕감퇴、소기라언、식후복창、대편희당、혈소판계수、뇨산、면역구단백G、홍세포침강솔、C-반응단백，E/A비치여병정、식욕감퇴、소기라언、식후복창、대편희당、a-산성당단백、백세포개소-17，사혈분수여병정、심계、권태핍력、식후복창、C3，FS,%여소기라언、삼선감유균정현저부상관（P<0.05혹P<0.01）。결론：강직성척주염환자존재심공능하강，표현위A봉승고，E봉、사혈분수、E/A비치강저，차여증상체정적분、실험실지표상관。강직성척주염환자심공능하강적궤제가능시유우기체내면역공능문란급세포인자실형인기심기수손도치。
Objective:To study the changes of heart function of patients with ankylosing spondylitis and analyze their correlativity with other indexes.Methods:Changes of heart function of 140 cases with ankylosing spondylitis were detected by ultrasonic cardiogram(UCG)and compared with those of 30 cases in the normal control group,observing their clinical symptoms,signs,laboratory indexes and their correlativity with parameters of cardiac function and exploring the mechanism.Results:①The abnormal rate of the ankylosing spondylitis group was 33.56% by UCG,while that of the normal control group was 9.99%,the difference being statistically signiifcant (P<0.01).②The blood stream peak of the late diastole(peak A)in the patients with ankylosing spondylitis increased signiifcantly(P<0.01);the blood stream peak of the early diastole(peak E),the ejection fraction(EF) and the ratio of E/A decreased signiifcantly (P<0.01). ③ The Spearman correlation analysis showed that there were positive correlations respectively between the heart function parameter peak E and interleukin-10,and between peak A and palpitations (P < 0.05 or P < 0.01).There were negative correlations respectively between peak E and duration of disease,loss of appetite,few words due to deficiency of qi,abdominal distention after eating,loose stool,blood platelet count,uric acid,immunoglobulin G,erythrocyte sedimentation rate and C-reactive protein,between E/A ratio and the course of disease,loss of appetite,few words due to deifciency of qi,abdominal distention after eating,loose stool,a-acidoglycoprotein and interleukin-17,between ejection fraction(EF)and the course,palpitations,fatigue,a bdominal distention after eating,C3,and between FS and few words due to deifciency of qi and triglyceride(P<0.05 or P<0.01).Conclusion:The cardiac function of patients with ankylosing spondylitis decreased,manifesting on the aspects of the increase of peak A and the decrease of peak E,ejection fraction(EF)and the ratio of E/A,and being relative with integrals of symptoms and signs and laboratory indexes.The mechanism of cardiac function decline in patients with ankylosing spondylitis might be myocardial damage due to its immune function disorder and cytokine imbalance.