摘要
目的超声心动图联合心电图评估抗中性粒细胞胞质抗体(ANCA)相关血管炎(AAV)患者心脏受累的情况。方法回顾性分析自2020年1月—2024年12月期间在济宁市第一人民医院诊治AAV患者的详细病历资料,从中纳入80例患者为AAV组,比较AAV组与对照组80例(年龄、性别、心血管疾病风险因素均相匹配)的心脏疾病的危险性。结果AAV组中78.75%患者出现心电图异常,对照组中仅在有临床症状的患者中出现重大心电图异常。在左房扩大、室间隔增厚方面,AAV组和对照组没有差异。AAV组左室收缩功能总体低于对照组(8.75%vs.0),AAV组舒张功能减低明显高于对照组(37.5%vs.15%)。AAV组对三尖瓣反流、二尖瓣反流、主动脉瓣反流、心包积液发生率明显高于对照组。在AAV组患者中可发现心包增厚、主动脉瓣狭窄、肺动脉高压及罕见的主动脉周围肉芽肿,而在对照组中均未发现。结论超声心动图、心电图是评估AAV心脏受累的重要检查方法,尤其在疾病的筛查、诊治、随访、判断预后中具有关键作用。
Objective To evaluate cardiac involvement in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis(AAV)using echocardiography combined with electrocardiography.Methods A retrospective analysis was performed on the detailed medical records of AAV patients treated in Jining First People’s Hospital between January 2020 and December 2024.Eighty patients were enrolled in the AAV group,and the risk of heart disease was compared between the AAV group and a control group with 80 subjects matched for age,sex,and cardiovascular disease risk factors.Results Electrocardiographic abnormalities were observed in 78.75%of patients in the AAV group,while significant electrocardiographic abnormalities only occurred in symptomatic patients in the control group.There were no differences in left atrial enlargement or interventricular septal thickening between the AAV group and the control group.The overall left ventricular systolic function in the AAV group was lower than that in the control group(8.75%vs.0).The incidence of reduced diastolic function in the AAV group was significantly higher than that in the control group(37.5%vs.15%).The incidence rates of tricuspid regurgitation,mitral regurgitation,aortic regurgitation,and pericardial effusion in the AAV group were significantly higher than those in the control group.Pericardial thickening,aortic stenosis,pulmonary hypertension,and rare periaortic granulomas were found in the AAV group,but not in the control group.Conclusion Echocardiography and electrocardiography are important examination methods for evaluating cardiac involvement in AAV.These methods have key roles in disease screening,diagnosis and treatment,follow-up,and prognosis judgment.
作者
路爱青
陈玲
孙秀云
董欣
李晓艳
孙永存
吕绍闻
于龙
张勇
LU Aiqing;CHEN Ling;SUN Xiuyun;DONG Xin;LI Xiaoyan;SUN Yongcun;LYU Shaowen;YU Long;ZHANG Yong(Department of Ultrasound of the First People’s Hospital of Jining,Jining 272100,China;Library of Jining Medical University,Jining 272100,China;Shandong First Medical University(School of Preventive Medicine Sciences),Jinan 250117,China)
出处
《中国辐射卫生》
2025年第4期534-539,共6页
Chinese Journal of Radiological Health
关键词
抗中性粒细胞胞质
血管炎
超声心动图
心电图
Anti-neutrophil cytoplasm
Vasculitis
Echocardiography
Electrocardiography
