目的 探讨超声速度向量成像技术评价射血分数正常的类风湿性关节炎患者左心室心肌收缩期力学功能.方法 自2016年1月至2017年1月,前瞻性收集我院收治的射血分数正常的类风湿性关节炎患者50例作为观察组,同期收集至我院健康体检的健康成人50例作为对照组.观察两组基底段、中间段和心尖段的收缩期平均峰值速度、收缩期平均峰值应变、收缩期平均峰值应变率.结果 两组患者左心射血分数(%)、左室缩短率、E/A值和e/a值等比较,差异均无统计学差异(P>0.05).与对照组比较,观察组患者基底段收缩期平均峰值速度、中间段收缩期平均峰值速度和心尖段收缩期平均峰值速度显著降低(P<0.05);基底段收缩期平均峰值应变、中间段收缩期平均峰值应变、心尖段收缩期平均峰值应变和基底段收缩期平均峰值应变率显著增高(P<0.05).两组患者中间段、心尖段收缩期平均峰值应变率均无统计学差异(P>0.05).结论 超声速度向量成像技术有助于识别类风湿性关节炎患者早期心功能损害.%Objective To evaluate the mechanical function of left ventricular systolic function in patients with normal rheumatoid arthritis with ejection fraction by ultrasonic velocity vector imaging. Methods From January 2016 to January 2017, we prospectively collected 50 patients with rheumatoid arthritis with normal ejection fraction in our hospital as an observation group. During the study period, 50 healthy adults admitted to our hospital for health examination were enrolled as a control group. The mean peak systolic velocity, peak strain and peak strain rate were observed in the basal, middle and apical segments of the two groups. Results There was no significant difference between the two groups in the left cardiac ejection fraction (%), left ventricular shortening rate, E/A value and e/a value (P>0.05). However, when compared with the control group, patients in the observation group got a reduction in systolic mean peak velocity of the basal segment, systolic mean peak velocity of the middle segments and systolic mean peak velocity of apical segments (P<0.05); an increased in systolic mean peak strain of the basal segment, systolic mean peak strain of the middle segments, systolic mean peak strain of the apical segments and mean peak strain rate of the basal segment (P=0.041). There were no significantly differences between the two groups in mean peak strain rate of the middle segments and apical segments (P>0.05). Conclusion Ultrasound velocity vector imaging is helpful to identify early cardiac function impairment in patients with rheumatoid arthritis.
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