超声多普勒主动脉僵硬度评价在系统性红斑狼疮中的应用
|
摘要
目的应用多普勒技术测量系统性红斑狼疮(SLE)患者的主动脉僵硬度指标:颈-股脉搏波传播速度(PWV)和心-股PWV,探讨其在SLE患者大血管病变评价中的临床价值。方法纳入30例在我院首次诊治的女性SLE住院患者。同时选取30例年龄、身高、体质量与患者组匹配的健康对照组。颈-股PWV及心-股PWV的测量采用超声多普勒法。结果 SLE患者与健康对照组在年龄、身高、体质量、血压、生化检查及左心室收缩功能指标对比无统计学差异(P>0.05)。SLE患者的颈-股PWV、心-股PWV分别为(7.88±1.84)m/s、(6.33±1.68)m/s,均显著高于对照组[分别为(6.71±0.78)m/s、(5.21±0.76)m/s,P<0.01]。心-股PWV与颈-股PWV测值在两组中均具有良好的相关性。结论基于超声多普勒测量的主动脉僵硬度指标,即颈-股PWV、心-股PWV,在SLE患者中显著增高,表明此类患者存在显著增高的心血管疾病风险。超声多普勒心-股PWV与颈-股PWV的无创测量为SLE患者主动脉僵硬度的临床评价提供了一种可靠方法。
Objective To investigate the aortic stiffness in patients with systemic lupus erythematosus(SLE)by measuring carotid-femoral pulse wave velocity(cfPWV)and heart-femoral PWV(hfPWV)using Doppler ultrasonography.The practical utility of this method for SLE′s macroangiopathy evaluation was discussed.Methods Thirty female firstly hospitalized SLE patients from department of rheumatology of Tangdu hospital were included in this study.Thirty female healthy volunteers were also recruited with age,height and weight strictly matched with SLE patients.The cfPWV and hfPWV of all subjects were measured by Doppler ultrasonography.Results There was no statistically significant difference in age,height,weight,blood pressure,biochemical examination,and indexes of left ventricular systolic and diastolic function between SLE patients and the healthy control group(all P>0.05).The cfPWV and hfPWV of SLE patients were higher than control group[(7.88±1.84)m/s vs(6.71±0.78)m/s,(6.33±1.68)m/s vs(5.21±0.76)m/s,both P<0.01].There was a good correlation between cfPWV and hfPWV values in both groups.Conclusions The results in this study indicate that the aortic stiffness,measured by cfPWV and hfPWV,was increased in SLE patients,representing a higher cardiovascular risk in these patients.The cfPWV and/or the hfPWV measured by Doppler ultrasonography provide an approach by which the aortic stiffness of SLE patients could be detected and evaluated.
Objective To investigate the aortic stiffness in patients with systemic lupus erythematosus(SLE)by measuring carotid-femoral pulse wave velocity(cfPWV)and heart-femoral PWV(hfPWV)using Doppler ultrasonography.The practical utility of this method for SLE′s macroangiopathy evaluation was discussed.Methods Thirty female firstly hospitalized SLE patients from department of rheumatology of Tangdu hospital were included in this study.Thirty female healthy volunteers were also recruited with age,height and weight strictly matched with SLE patients.The cfPWV and hfPWV of all subjects were measured by Doppler ultrasonography.Results There was no statistically significant difference in age,height,weight,blood pressure,biochemical examination,and indexes of left ventricular systolic and diastolic function between SLE patients and the healthy control group(all P>0.05).The cfPWV and hfPWV of SLE patients were higher than control group[(7.88±1.84)m/s vs(6.71±0.78)m/s,(6.33±1.68)m/s vs(5.21±0.76)m/s,both P<0.01].There was a good correlation between cfPWV and hfPWV values in both groups.Conclusions The results in this study indicate that the aortic stiffness,measured by cfPWV and hfPWV,was increased in SLE patients,representing a higher cardiovascular risk in these patients.The cfPWV and/or the hfPWV measured by Doppler ultrasonography provide an approach by which the aortic stiffness of SLE patients could be detected and evaluated.
引文
[1]CHANG J C,KNIGHT A M,XIAO R,et al.Use of echocardiography at diagnosis and detection of acute cardiac disease in youth with systemic lupus erythematosus[J].Lupus,2018,27(8):1348-1357.
[2]LAURENT S,COCKCROFT J,VAN B L,et al.Expert consensus document on arterial stiffness:methodological issues and clinical applications[J].Eur Heart J,2006,27(21):2588-2605.
[3]BEN-SHLOMO Y,SPEARS M,BOUSTRED C,et al.Aortic pulse wave velocity improves cardiovascular event prediction:an individual participant meta-analysis of prospective observational data from 17,635subjects[J].J Am Coll Cardiol,2014,63(7):636-646.
[4]HOCHBERG M C.Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus[J].Arthritis Rheum,1997,40(9):1725.
[5]梁宇彤,周田,王臻,等.超声多普勒脉搏波传播速度评价在大动脉炎中的应用[J].中国超声医学杂志,2017,33(2):177-179.
[6]STYCZYNSKI G,RDZANEK A,PIETRASIK A,et al.Echocardiographic assessment of aortic pulse-wave velocity:Validation against Invasive Pressure Measurements[J].J Am Soc Echocardiogr,2016,29(11):1109-1116.
[7]VAN B L M,LAURENT S,BOUTOUYRIE P,et al.Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity[J].JHypertens,2012,30(3):445-448.
[8]WANG Z,YANG Y,YUAN L J,et al.Noninvasive method for measuring local pulse wave velocity by dual pulse wave Doppler:in vitro and in vivo studies[J].PLoS One,2015,10(3):e0120482.
[9]WANG P,MAO Y M,ZHAO C N,et al.Increased Pulse Wave Velocity in Systemic Lupus Erythematosus:A Meta-Analysis[J].Angiology,2018,69(3):228-235.
[10]PRASAD M,HERMANN J,GABRIEL S E,et al.Cardiorheumatology:cardiac involvement in systemic rheumatic disease[J].Nat Rev Cardiol,2015,12(3):168-176.
[2]LAURENT S,COCKCROFT J,VAN B L,et al.Expert consensus document on arterial stiffness:methodological issues and clinical applications[J].Eur Heart J,2006,27(21):2588-2605.
[3]BEN-SHLOMO Y,SPEARS M,BOUSTRED C,et al.Aortic pulse wave velocity improves cardiovascular event prediction:an individual participant meta-analysis of prospective observational data from 17,635subjects[J].J Am Coll Cardiol,2014,63(7):636-646.
[4]HOCHBERG M C.Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus[J].Arthritis Rheum,1997,40(9):1725.
[5]梁宇彤,周田,王臻,等.超声多普勒脉搏波传播速度评价在大动脉炎中的应用[J].中国超声医学杂志,2017,33(2):177-179.
[6]STYCZYNSKI G,RDZANEK A,PIETRASIK A,et al.Echocardiographic assessment of aortic pulse-wave velocity:Validation against Invasive Pressure Measurements[J].J Am Soc Echocardiogr,2016,29(11):1109-1116.
[7]VAN B L M,LAURENT S,BOUTOUYRIE P,et al.Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity[J].JHypertens,2012,30(3):445-448.
[8]WANG Z,YANG Y,YUAN L J,et al.Noninvasive method for measuring local pulse wave velocity by dual pulse wave Doppler:in vitro and in vivo studies[J].PLoS One,2015,10(3):e0120482.
[9]WANG P,MAO Y M,ZHAO C N,et al.Increased Pulse Wave Velocity in Systemic Lupus Erythematosus:A Meta-Analysis[J].Angiology,2018,69(3):228-235.
[10]PRASAD M,HERMANN J,GABRIEL S E,et al.Cardiorheumatology:cardiac involvement in systemic rheumatic disease[J].Nat Rev Cardiol,2015,12(3):168-176.