摘要
目的:运用左心室自动功能成像探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)早期心脏受累以及血液指标与心脏功能的相关性。方法:选取2023年4月至2024年4月期间安徽医科大学附属六安医院住院的83例符合诊断标准的SLE患者,收集患者临床资料及生化指标,临床资料包括年龄、收缩压、舒张压、药物治疗、CRP、类风湿因子(rheumatoid factor,RF)等。通过AFI分析左心室整体纵向应变均值(global longitudinal strain,GLS),以GLS绝对值18%为临界值,将患者分为GLS减低组和正常组,比较两组心脏形态和功能参数。采用Pearson相关分析评估SLE患者的临床及生化指标与心脏功能的相关性。结果:超声心动图AFI分析显示,36.1%的SLE患者存在左心室心肌损伤。与正常组相比,GLS减低组的二尖瓣环舒张早期速度(e')[(10.7±0.7)vs.(11.3±1.0)cm/s,P=0.010]和三尖瓣环舒张早期速度(e')[(11.2±0.9)vs.(12.2±1.2)cm/s,P<0.001]均处于亚临床状态。此外,GLS减低组的三尖瓣环平面收缩期偏移(tricuspid annular plane systolic excursion,TAPSE)[(18.4±1.3)vs.(21.5±2.9)mm,P<0.001]和组织多普勒三尖瓣(S')[(10.6±1.0)vs.(12.3±1.6)mm,P<0.001]也明显减低,提示部分左心室功能障碍患者同时存在右心室功能障碍。Pearson相关分析显示,补体C4与S'、TAPSE和GLS呈正相关(相关系数分别为0.557、0.550、0.650,P<0.05)。结论:SLE患者可出现早期的心脏功能受损,其中补体C4与心肌损伤相关。
Objective:To investigate early cardiac involvement in systemic lupus erythematosus(SLE)using left ventricular automated function imaging and the correlation between laboratory parameters and cardiac function.Methods:Eighty-three SLE patients who met the diagnostic criteria and were hospitalized in The Sixth Affiliated Hospital of Anhui Medical University in Lu'an Hospital between April 2023 and April 2024 were selected,and clinical data and biochemical indexes were collected from the patients,which included age,systolic blood pressure,diastolic blood pressure,medication,CRP,rheumatoid factor(RF),and blood pressure(BP),as well as the correlation between early cardiac involvement and cardiac function.factor(RF),and so on.The mean value of the overall longitudinal strain of the left ventricle global longitudinal strain(GLS)was analyzed by AFI,and the absolute value of GLS 18%was used as the critical value,and the patients were divided into the reduced GLS group and the normal group,and the cardiac morphology and functional parameters of the two groups were compared.Pearson correlation analysis was used to assess the correlation between clinical and biochemical parameters and cardiac function in SLE patients.Results:Echocardiographic AFI analysis showed that 36.1%of SLE patients had left ventricular myocardial damage.Compared to the normal group,the mitral annular early diastolic velocity(e')[(10.7±0.7)vs.(11.3±1.0)cm/s,P=0.010]and tricuspid annular early diastolic velocity(e')[(11.2±0.9)vs.(12.2±1.2)cm/s,P<0.001]in the GLS-reduced group were in a sub clinical status.In addition,tricuspid annular plane systolic excursion(TAPSE)[(18.4±1.3)vs.(21.5±2.9)mm,P<0.001]and tissue Doppler tricuspid(S')[(10.6±1.0)vs.(12.3±1.6)mm,P<0.001]were also significantly reduced,suggesting concomitant right ventricular dysfunction in some patients with left ventricular dysfunction.Pearson correlation analysis showed a positive correlation between complement C4 and S',TAPSE and GLS(correlation coefficients 0.557,0.550,0.650,P<0.05,respectively).Conclusions:Patients with SLE can present early impaired cardiac function,in which complement C4 is associated with myocardial damage.
作者
陈润
李胜男
曹彦
胡忠顺
倪丹凤
杜自慧
CHEN Run;LI Shengnan;CAO Yan;HU Zhongshun;NI Danfeng;DU Zihui(The Sixth Affiliated Hospital of Anhui Medical University in Lu'an,Bengbu 237000,China)
出处
《心肺血管病杂志》
2025年第8期865-870,共6页
Journal of Cardiovascular and Pulmonary Diseases
基金
安徽医科大学附属六安医院科研面上项目(2022kykt27)。
关键词
系统性红斑狼疮
心脏功能
补体C4
Systemic lupus erythematosus
Cardiac function
Complement C4
