CAJ | 학술논문

目的探讨组织多普勒技术(TDI)用于评价多发性肌炎/皮肌炎患者早期心脏受累的价值；分析多发性肌炎/皮肌炎患者早期心脏受累的危险因素.方法选择临床无心脏受累症状的46例多发性肌炎/皮肌炎患者和性别、年龄匹配的21名健康对照者,分别用普通超声心动图和TDI检查心脏的结构与功能.对比分析普通超声心动图和TDI各项参数对检出多发性肌炎/皮肌炎心脏受累的差异,通过多因素Logistic回归分析多发性肌炎/皮肌炎患者早期心脏受累的危险因素.采用t检验、x2检验和Logistic回归分析进行统计学分析.结果多发性肌炎/皮肌炎组与健康对照组比较,常规超声心动图参数、二尖瓣环6个位点和三尖瓣环2个位点平均收缩期峰值速度(Sm)差异无统计学意义.多发性肌炎/皮肌炎组二尖瓣环平均舒张早期与舒张晚期峰值速度比(Em/Am) (1.2±0.5)和三尖瓣环Em/Am(1.0±0.3)较健康对照组(分别为1.8±0.4,1.5±0.3)明显减低(t值分别为-4.485,-5.278; P＜0.01).多发性肌炎组患者和皮肌炎组患者TDI检测各项指标差异无统计学意义.多因素Logistic回归分析显示发病年龄[OR=1.534,95％CI(1.051,2.240)]和病程[OR=1.205,95％CI(1.049,1.385)]是多发性肌炎/皮肌炎组患者早期左心室舒张功能不全的危险因素；而发病年龄[OR=1.146,95％CI(0.989,1.329)]是早期右心室舒张功能不全的危险因素.结论与普通超声心动检查相比,TDI检测方法可以早期发现多发性肌炎/皮肌炎患者伴有左右心室舒张功能不全.患者发病年龄和病程是多发性肌炎/皮肌炎患者出现左心舒张功能不全的危险因素.临床上对于中老年发病和病程长的多发性肌炎/皮肌炎患者应重视心脏受累的情况.
목적 탐토조직다보륵기술(TDI)용우평개다발성기염/피기염환자조기심장수루적개치；분석다발성기염/피기염환자조기심장수루적위험인소.방법 선택림상무심장수루증상적46례다발성기염/피기염환자화성별、년령필배적21명건강대조자,분별용보통초성심동도화TDI검사심장적결구여공능.대비분석보통초성심동도화TDI각항삼수대검출다발성기염/피기염심장수루적차이,통과다인소Logistic회귀분석다발성기염/피기염환자조기심장수루적위험인소.채용t검험、x2검험화Logistic회귀분석진행통계학분석.결과 다발성기염/피기염조여건강대조조비교,상규초성심동도삼수、이첨판배6개위점화삼첨판배2개위점평균수축기봉치속도(Sm)차이무통계학의의.다발성기염/피기염조이첨판배평균서장조기여서장만기봉치속도비(Em/Am) (1.2±0.5)화삼첨판배Em/Am(1.0±0.3)교건강대조조(분별위1.8±0.4,1.5±0.3)명현감저(t치분별위-4.485,-5.278; P＜0.01).다발성기염조환자화피기염조환자TDI검측각항지표차이무통계학의의.다인소Logistic회귀분석현시발병년령[OR=1.534,95％CI(1.051,2.240)]화병정[OR=1.205,95％CI(1.049,1.385)]시다발성기염/피기염조환자조기좌심실서장공능불전적위험인소；이발병년령[OR=1.146,95％CI(0.989,1.329)]시조기우심실서장공능불전적위험인소.결론 여보통초성심동검사상비,TDI검측방법가이조기발현다발성기염/피기염환자반유좌우심실서장공능불전.환자발병년령화병정시다발성기염/피기염환자출현좌심서장공능불전적위험인소.림상상대우중노년발병화병정장적다발성기염/피기염환자응중시심장수루적정황.
Objective To investigate the value of tissue Doppler echocardiography (TDI) in ventricular myocardial function in patients with polymyositis/dermatomyositis (PM/DM) and the risk factors for early cardiac involvement was explored.Methods The study population included 46 PM/DM patients without symptoms of heart involvement and 21 healthy controls.The examination results of traditional echocardiography and TDI between patients and health subjects were compared.Multivariate Logistic regression analysis was applied to investigate the risk factors for early cardiac complications.T test,x2 test and Logistic regression were used for statistical analysis.Results No significant difference was found in traditional echocardiography between patients with PM/DM and healthy subjects.The ratio of early diastolic mitral annulus velocity to late diastolic mitral annulus velocity (1.2±0.5,1.8±0.4) and early tricuspid annulus velocity to late tricuspid annulus velocity (1.0±0.3,1.5±0.3) were significantly different in PM/DM and healthy subjects (t=-4.485,-5.278; P＜0.01).There were no significant differences in TDI between patients with PM and DM.The multifactor Logistic regression analysis showed that the age of onset [0R=1.534,95％CI (1.051,2.240)] and duration of disease[OR=1.205,95％CI (1.049,1.385)] were risk factors for early left ventricular diastolic dysfunction,and age of onset [OR=1.146,95％CI (0.989,1.329)] was risk factor for early right ventricular diastolic dysfunction.Conclusion TDI may provide additional information for detecting early ventricular diastolic dysfunction in patients with PM/DM.The age of onset and duration of disease are risk factors for left ventricular diastolic dysfunction.More attention should be paid to cardiac involvement in patients with PM/DM.