CAJ | 학술논문

目的：探讨三维斑点追踪成像(3D-STI)技术评价系统性红斑狼疮(systemic lupus erythematosus,SLE)患者左室整体和局部收缩功能的价值。方法选取22例SLE患者为SLE组,另选性别、年龄相匹配的22例正常人为对照组。均行3D-STI 检查,获取左室整体纵向应变(GLS)、环向应变(GCS)、径向应变(GRS)、面积应变(GAS)和局部纵向应变(SLS)、环向应变(SCS)、径向应变(SRS)、面积应变(SAS)。绘制 ROC曲线获得整体环向应变及整体面积应变检测 SLE 患者左室收缩功能减低的敏感性及特异性。结果①整体应变：与对照组比较,GCS及 GAS明显降低(P <0.01),GLS和 GRS无明显变化(P >0.05)。②局部应变：与对照组比较,SLE组前壁基底段及侧壁心尖段 SLS明显减低；前间隔及下间隔基底段,前壁、下间隔及前侧壁中间段,下壁及侧壁心尖段 SCS明显减低；下间隔基底段、中间段,前壁及侧壁心尖段 SRS明显减低；前壁及下间隔基底段,下间隔及前侧壁中间段,前壁及侧壁心尖段 SAS明显减低(P <0.01)；心尖部 SCS减低；前壁及室间隔中间段,心尖部 SAS减低(P <0.05)。③ROC 曲线：GCS评价左室收缩功能减低的敏感性和特异性分别为59.1%和87.5%；GAS评价左室收缩功能减低的敏感性和特异性分别为77.3%和83.3%。结论3D-STI能够发现 SLE患者早期左室的整体和局部收缩功能异常,是一项便捷、准确的好方法。
목적：탐토삼유반점추종성상(3D-STI)기술평개계통성홍반랑창(systemic lupus erythematosus,SLE)환자좌실정체화국부수축공능적개치。방법선취22례SLE환자위SLE조,령선성별、년령상필배적22례정상인위대조조。균행3D-STI 검사,획취좌실정체종향응변(GLS)、배향응변(GCS)、경향응변(GRS)、면적응변(GAS)화국부종향응변(SLS)、배향응변(SCS)、경향응변(SRS)、면적응변(SAS)。회제 ROC곡선획득정체배향응변급정체면적응변검측 SLE 환자좌실수축공능감저적민감성급특이성。결과①정체응변：여대조조비교,GCS급 GAS명현강저(P <0.01),GLS화 GRS무명현변화(P >0.05)。②국부응변：여대조조비교,SLE조전벽기저단급측벽심첨단 SLS명현감저；전간격급하간격기저단,전벽、하간격급전측벽중간단,하벽급측벽심첨단 SCS명현감저；하간격기저단、중간단,전벽급측벽심첨단 SRS명현감저；전벽급하간격기저단,하간격급전측벽중간단,전벽급측벽심첨단 SAS명현감저(P <0.01)；심첨부 SCS감저；전벽급실간격중간단,심첨부 SAS감저(P <0.05)。③ROC 곡선：GCS평개좌실수축공능감저적민감성화특이성분별위59.1%화87.5%；GAS평개좌실수축공능감저적민감성화특이성분별위77.3%화83.3%。결론3D-STI능구발현 SLE환자조기좌실적정체화국부수축공능이상,시일항편첩、준학적호방법。
Objective To evaluate left ventricular(LV)global and regional systolic function by three-dimensional speckle tracking imaging (3D-STI)in patients with systemic lupus erythematosus (SLE). Methods Twenty-two patients with SLE were selected randomly as SLE group and twenty-two healthy people were included as control group.3D-STI was performed in all participants to get global and regional strain parameters,including global longitudinal peak systolic strain(GLS),global circular peak systolic strain (GCS ),global radial peak systolic strain (GRS ),global area peak systolic strain (GAS ),segmental longitudinal peak systolic strain (SLS),segmental circumferential peak systolic strain (SCS),segmental radial peak systolic strain (SRS),and segmental area peak systolic strain (SAS).The sensitivity and specificity of GCS and GAS reflecting LV systolic function in patients with SLE were analyzed under the receiver operating characteristic (ROC)curve.Results ①The global strain:compared with the control group,GCS and GAS decreased significantly in SLE group (P <0.01),there was no significant change in GLS and GRS(P >0.05).②The regional strain:compared with the control group,the SCS in segments of basal anteroseptal,basal inferoseptal,mid anterior,mid inferosptal,mid anterolateral,apical inferior,apical lateral decreased significantly in SLE group.The SAS of basal anterior,basal inferoseptal,mid inferosptal, mid anterolateral,apical anterioe,apical lateral decreased significantly in SLE group (P <0.01).The SCS in segments of apex and the SAS of mid anterior,apical septal,apex decreased in SLE group (P <0.05).③The ROC curve:the sensitivity and specificity of GCS on detecting the LV systolic dysfunction were 59.1%and 87.5%,and those of GAS were 77.3% and 83.3%,respectively.Conclusions 3D-STI is a convenient and accurate way to early detect LV global and regional systolic dysfunction in SLE patients.