目的 探讨弹力带抗阻训练对老年人骨骼肌功能的影响。方法 在我院筛选60例老年人随机分为两组,对照组30例患者采用常规康复训练,观察组30例患者采用弹力带抗阻训练;分别于干预前及干预3月后评价骨骼肌功能,分析跌倒风险指数。结果 对照组干预前后骨骼肌质量指数、握力、歩速以及平衡量表BBS评分比较无差异(P>0.05);观察组干预后骨骼肌质量指数、6 m步速、握力均高于对照组,平衡量表BBS评分低于对照组(P<0.05)。结论 弹力带抗阻训练能够提高老年人骨骼肌质量、改善老年人握力计和歩速,提高平衡能力。

Objective To investigate the effect of elastic band resistance training on skeletal muscle function in the elderly. Methods 60 elderly patients in our hospital were selected and randomly divided into two groups. 30 patients in the control group received conventional rehabilitation training, while 30 patients in the observation group received elastic band resistance training. Skeletal muscle function was evaluated before intervention and 3 months after intervention, and the fall risk index was analyzed. Results There were no significant differences in skeletal muscle mass index, grip strength, pacing and BBS scores of balance scale before and after intervention in the control group (P>0.05). After intervention, the skeletal muscle mass index, 6 m step speed and grip strength of the observation group were all higher than those of the control group, and the BBS score of balance scale was lower than that of the control group (P<0.05). Conclusion The elastic band resistance training can improve the skeletal muscle quality, improve grip strength and pacing, and improve the balance ability in the elderly.

目的 观察结直肠癌患者使用联合药物FOLFOX化疗前后左心室应变参数的变化。方法 选取健康人30例作为正常组,收集病理确诊为结直肠癌并采用FOLFOX(5-氟尿嘧啶+奥沙利铂+亚叶酸钙)化疗的患者30例,以自身对照做研究,分别在化疗前、化疗1个周期后、化疗6个周期后、化疗12个周期后48 h内完成心脏超声检查,采集左心室的动态图像,获取常规参数:LVEDd、LVEDs、IVSd、LVPWd、LVEDV、LVESV、LVEF、LVFS;三维参数:SPI、SV、CO、LVEDMass、LVESMass、GAS、GRS、GLS、GCS,并比较化疗前后这些数值的变化。结果 正常组与各化疗组相比对,LVEDd、LVEDs、IVSd、LVPWd、LVPW、LVESV、SPI的变化均无统计学意义(P>0.05);LVEF、LVFS、SV、CO在化疗中、后期出现了降低,差异有统计学意义(P<0.05),HR、LVEDMass、LVESMass略升高,差异有统计学意义(P<0.05);化疗后GLS及GAS较化疗前明显减低(P<0.05),其中GAS的ROC曲线下面积为0.883,P<0.001,选30%为诊断界点,灵敏度为86.7%,特异度为80%;GLS的ROC曲线下面积为0.888,P<0.001,选19%为诊断界点,灵敏度为73.3%,特异度为90.0%。结论 三维斑点追踪技术能够早期发现FOLFOX致结直肠癌患者左心室功能的变化,其中LVGLS、LVGAS是有力的观测指标。

Objective To observe the changes of left ventricular strain parameters in patients with colorectal cancer before and after combined chemotherapy with FOLFOX. Methods 30 healthy people were selected as normal group, and 30 patients with pathologically diagnosed colorectal cancer and FOLFOX (5-fluorouracil +oxaliplatin+calcium leucovorin) chemotherapy were collected. Before, after 1 cycle of chemotherapy, after 6 cycles of chemotherapy, and within 48 hours after 12 cycles of chemotherapy, cardiac ultrasound examination was performed, and dynamic images of the left ventricle were collected to obtain conventional parameters: LVEDd, LVEDs, IVSd, LVPWd, LVEDV, LVESV, LVEF, LVFS; three-dimensional parameters: SPI, SV, CO, LVEDMass, LVESMass, GAS, GRS, GLS, GCS, and the changes of these values before and after chemotherapy were compared. Results Compared with the chemotherapy group, the normal group had no statistically significant changes in LVEDd, LVEDs, IVSd, LVPWd, LVPW, LVESV, and SPI (P>0.05); LVEF, LVFS, SV, CO were in the middle and late stages of chemotherapy. There was a decrease, the difference was statistically significant (P<0.05), HR, LVEDMass, LVEESMass were slightly increased, the difference was statistically significant (P<0.05); LGS and GAS after chemotherapy were significantly lower than before chemotherapy (P<0.05), the area under the ROC curve of GAS is 0.883, P=0.000, 30% is selected as the diagnostic boundary, the sensitivity is 86.7%, and the specificity is 80%; the area under the ROC curve of GLS is 0.888, P=0.000, 19% as a diagnostic boundary, the sensitivity is 73.3% and the specificity is 90.0%. Conclusion Three-dimensional speckle tracking technology can detect the changes of left ventricular function in patients with colorectal cancer caused by FOLFOX in early stage, of which LVLGS and LVGAS are powerful observation indicators.

目的 探讨延续性健康指导联合预见性干预对慢性脑卒中患者脑功能影响。方法 选取2019年6月—2020年6月我院收治的慢性脑卒中患者118例,使用随机数字表法将其分为两组,对照组进行预见性干预,研究组进行延续性健康指导联合预见性干预。比较两组效果、神经运动功能、不良反应。结果 研究组效果大于对照组(P＜0.05);研究组神经运动功能大于对照组(P＜0.05);研究组不良反应少于对照组(P＜0.05)。结论 慢性脑卒中护理中,延续性健康指导联合预见性干预效果较好,值得应用。

Objective To investigate the effects of continuous health guidance and combined predictive intervention on cerebral function in patients with chronic stroke. Methods A total of 118 patients with chronic stroke admitted to our hospital from June 2019 to June 2020 were selected and divided into two groups using the random number table method. The control group received predictive intervention, and the study group received continuous health guidance combined predictive intervention. The effects, neuromotor functions and adverse reactions of the two groups were compared. Results The effect of the study group was greater than that of the control group (P<0.05). The neuromotor function of the study group was higher than that of the control group (P<0.05). The adverse reactions in the study group were less than those in the control group (P<0.05). Conclusion In the nursing of chronic stroke, the effect of continuous health guidance combined with predictive intervention is good, and it is worth applying.

目的 探讨选择性会阴侧切术对会阴体及产后盆底功能的影响。方法 选取2018年1月—2019年12月在广州市红十字会医院顺产的初产妇作为研究对象,研究组为选择性会阴侧切组、对照组为常规治疗,统计两组的会阴裂伤情况,盆底Ⅰ类肌、Ⅱ类肌肌力分级,POPQ评分的分级,肛提肌裂孔扩张情况。结果 会阴裂伤率:研究组2.5%,对照组为56.22%,连续性校正χ²为53.14,连续性校正P＜0.05。盆底Ⅰ类、Ⅱ类肌力＜3级发生率:研究组分别为30%、23%,对照组分别为 49%、38%,χ²分别为9.03、5.96,P＜0.05。POPQ 0级率:研究组26.25%,对照组12.5%,χ²为4.84,P＜0.05。肛提肌裂孔无扩张率:研究组16.25%,对照组为5%,χ²为5.33,P＜0.05。结论 在本研究中,与对照组相比,研究组会阴裂伤率、盆底肌力<3级发生率更低;盆腔器官无脱垂率、肛提肌裂孔无扩张率更高。选择性会阴侧切术对会阴体及盆底功能具有保护作用。

Objective To investigate the effect of selective lateral episiotomy on perineal body and pelvic floor function. Methods The primiparas who delivered naturally in Guangzhou Red Cross Hospital from January 2018 to December 2019 were selected as the research subjects. The research group were given selective lateral episiotomy, while the control group were given conventional treatment. The incidence of perineal laceration, pelvic floor muscle strength lower than grade 3, the POPQ score and levator ani hiatus dilatation were analyzed. Chi-square test was used to analyze the incidence of the two groups. Results The incidence of perineal laceration in the research group was 2.5% vs 56.22% in the control group(χ²=53.14, P<0.05). The incidence of pelvic floor muscle(group I) strength lower than grade 3 in the research group was 30% vs 49% in the control group(χ²=9.03, P<0.05). The incidence of pelvic floor muscle(group II) strength lower than grade 3 in the research group was 23% vs 38% in the control group(χ²=5.96, P<0.05). The rate of the incidence of POPQ 0 in the research group was 26.25% vs 12.5% in the control group (χ²=4.84,P＜0.05). The incidence of levator ani hiatus dilatation in the research group was 16.25%, while 5% in the control group (χ²=5.33, P<0.05). Conclusion Compared with conventional treatment group, selective lateral episiotomy group has a lower incidence of perineal laceration and pelvic floor muscle strength lower than grade 3. Selective lateral episiotomy group has a higher incidence of POPQ 0 and no levator ani hiatus dilatation. Selective lateral episiotomy can protect the perineal body and pelvic floor function.

目的 分析慢性肾衰竭患者接受肾衰康方治疗对其血清微炎症状态的影响及肾功能的保护作用。方法 将2020年1月—2020年12月作为研究时间段,选取期间广东祈福医院接诊的50例慢性肾衰竭患者,另将随机数字表法作为分组依据,将全部病例分为对照组(行常规治疗,纳入25例)、观察组(加用肾衰康方治疗,纳入25例),对组间中医症状评分、血清微炎症状态、肾功能指标、氧化应激指标展开分析。结果 组间中医症状评分、血清微炎症状态、肾功能指标、氧化应激指标在治疗前无明显差异,P>0.05;观察组中医症状评分、血清微炎症状态、肾功能指标、氧化应激指标在治疗后优于对照组,P<0.05。结论 肾衰康方对改善慢性肾衰竭患者血清微炎症状态、氧化应激水平、临床症状均有较好效果,且能保护肾功能,值得推广。

Objective To analyze the effect of Shenshuaikang decoction on serum microinflammation and renal function in patients with chronic renal failure. Methods From January 2020 to December 2020, 50 patients with chronic renal failure treated by Clifford Hospital were selected, and the random number table method was used for grouping. All cases were divided into control group (n=25) and observation group (n=25). The TCM symptom score, serum microinflammatory state, renal function index and oxidative stress index were analyzed. Results There were no significant differences in TCM symptom score, serum microinflammatory state, renal function index and oxidative stress index between the two groups before treatment, P>0.05; the TCM symptom score, serum microinflammatory state, renal function index and oxidative stress index of the observation group were better than those of the control group after treatment, P<0.05. Conclusion Shenshuaikang decoction has good effect on improving serum microinflammation, oxidative stress level and clinical symptoms of patients with chronic renal failure, and also can protect renal function, which is worthy of promotion.

目的 探讨肝硬化患者临床凝血功能检验中全自动血凝仪测定的应用及临床价值。方法 选取2018年1月—2020年1月我院收治的64例肝硬化患者(肝硬化组),并纳入同期来我院接受健康体检者64例(对照组),应用全自动血凝仪对肝硬化患者临床凝血指标检测。再将肝硬化组患者分为出血组与无出血组,比较对照组与肝硬化组、出血与无出血组、不同肝功能分级患者血小板参数与PT检测结果。结果 与对照组比较,肝硬化组PDW、PT、MPV、INR水平更高,PCT、PLT水平更低(P＜0.05);与肝硬化无出血组比较,肝硬化出血组PDW、PT、MPV、INR水平更高,PCT、PLT水平更低(P＜0.05);与Child-Pugh A级患者比较,肝硬化Child-Pugh B级与C级患者PDW、PT、MPV、INR水平更高,PCT、PLT水平更低(P＜0.05)。结论 在肝硬化患者病情评价中凝血功能检验发挥重要作用,可为患者临床治疗提供有效理论依据,诊断准确率较高,有利于临床治疗措施制定。因此,凝血功能检验应在肝硬化疾病诊断中广泛应用。

Objective To explore the application and clinical value of automatic blood coagulation apparatus in clinical coagulation function test of patients with cirrhosis. Methods A total of 64 patients with cirrhosis admitted to our hospital from January 2018 to January 2020 (cirrhosis group) were selected, and 64 healthy subjects admitted to our hospital during the same period (control group) were included. The clinical coagulation indexes of patients with cirrhosis were detected by automatic blood coagulation apparatus. Patients in cirrhosis group were divided into bleeding group and non-bleeding group; platelet parameters and PT test results were compared between control group and cirrhosis group, bleeding group and non-bleeding group, and patients with different liver function grades. Results Compared with the control group, the levels of PDW, PT, MPV and INR in cirrhosis group were higher, and the levels of PCT and PLT were lower (P＜0.05). Compared with liver cirrhosis non-bleeding group, the levels of PDW, PT, MPV and INR were higher in liver cirrhosis with bleeding group, and the levels of PCT and PLT were lower (P＜0.05). Compared with Child-Pugh A patients, the levels of PDW, PT, MPV and INR in Child-Pugh B and C patients with cirrhosis were higher, and the levels of PCT and PLT were lower (P＜0.05). Conclusion The test of coagulation function plays an important role in the evaluation of patients with cirrhosis, and can provide effective theoretical basis for the clinical treatment of patients with high diagnostic accuracy, which is conducive to the formulation of clinical treatment measures. Therefore, the test of coagulation function should be widely used in the diagnosis of cirrhosis.

目的 探讨糖尿病肾病患者肾功能恶化的危险因素。 方法 采用回顾性队列研究分析山东省立第三医院2017年1月—2020年5月108例患者的临床数据。将病人分为糖尿病肾病肌酐翻倍组和不翻倍组,比较两组间临床数据的变化。结果 糖尿病肾病肌酐翻倍组的BUN、胱抑素C和ACR水平均高于肌酐不翻倍组;eGFR、CO₂、ALB、HGB均低于肌酐不翻倍组,差异有统计学意义(P<0.05)。而UA、GLU、血脂、糖化血红蛋白,糖尿病和高血压病史差异无统计学意义(P>0.05)。相关分析表明血肌酐与BUN、eGFR、胱抑素C、ACR呈正相关;与ALB,HGB和CO₂呈负相关。多元线性回归分析结果显示,eGFR,胱抑素C,ACR, ALB和HGB是糖尿病肾病肾功能恶化的影响因素(P<0.05)。结论 糖尿病肾病除检测肾功能的常规指标外,还可观察ACR、ALB和HGB水平的变化,对判断患者肾功能是否恶化有一定价值。

Objective To investigate the risk factors of renal function deterioration in patients with diabetic nephropathy. Methods Retrospective cohort study was used to analyze the clinical data of 108 patients from January 2017 to May 2020 in the Third Hospital of Shandong Province. Patients were divided into diabetic nephropathy creatinine doubling group and non-doubling group. The changes of clinical data in two groups were compared and the risk factors of renal function deterioration were analyzed. Results The levels of BUN、cystatin C and ACR in the creatinine doubling group were higher than those in the creatinine non-doubling group, and the levels of eGFR、CO₂、ALB、 HGB were lower than those in the creatinine non-doubling group, the differences were statistically significant (P<0.05). However, there were no significant differences in the levels of UA, blood glucose, blood lipid, glycosylated hemoglobin, the history of diabetes and hypertension (P>0.05). The correlation analysis showed that serum creatinine was positively correlated with BUN、 eGFR、cystatin C and ACR and negatively correlated with CO₂、ALB and HGB. The results of multiple regression analysis showed that eGFR、cystatin C、ACR、ALB and HGB were independent influencing factors of renal function deterioration(all P<0.05). Conclusion Diabetic nephropathy can not only notice the routine indexes of renal function, but also observe the changes of ACR、ALB and HGB levels, which has certain value for awareing the renal function deterioration in patients.

目的 探讨睫毛蠕形螨感染与睑板腺功能障碍(meibomian gland dysfunction,MGD)发生的相关性,并分析睫毛蠕形螨感染对MGD患者眼表症状跟体征的影响。方法 前瞻性队列研究。选取2018年7月—2019年3月在广州市第一人民医院眼科门诊诊断为MGD患者47例,按照年龄将MGD患者分别纳入MGD＜40岁组(A₁组,28例)和MGD＞60岁组(B₁组,19例)。根据蠕形螨检测结果将MGD患者分别纳入蠕形螨检出阳性组(Ⅰ组,22例)与蠕形螨检出阴性组(Ⅱ组,25例)。同时,选取无MGD正常人或仅患屈光不正、玻璃体混浊的患者共49例,按照年龄将其分别纳入NMGD＜40岁组(A₂组,30例)和NMGD＞60岁组(B₂组,19例)。主要统计受试者眼部症状(眼痒、眼痛、眼干、异物感、视物模糊)发生率、睫毛蠕形螨检出数量及检出率、睑板腺排出能力评分、睑板腺分泌物性状评分及眼表疾病指数(Ocular Surface Disease Index,OSDI)。结果 MGD＜40岁组(A₁组)与NMGD＜40岁组(A₂组)睫毛蠕形螨检出数量分别为(1.14±1.938)、(0.17±0.531)只,差异有统计学意义(P=0.003,＜0.05),睫毛蠕形螨检出阳性率分别为43%、10%,差异有统计学意义(P=0.006,＜0.05);MGD＞60岁组(B₁组)与NMGD＞60岁组(B₂组)睫毛蠕形螨检出数量分别为(1.89±2.331)、(0.68±1.529)只,差异没有统计学意义(P＞0.05),睫毛蠕形螨检出阳性率分别为53%、21%,差异没有统计学意义(P＞0.05); MGD患者睫毛蠕形螨检出阳性组(Ⅰ组)与MGD患者睫毛蠕形螨检出阴性组(Ⅱ组)睑板腺分泌物性状评分分别为(3.00±1.11)、(2.28±1.28),差异有统计学意义(P＝0.047,＜0.05);Ⅰ组OSDI、睑板腺排出能力评分、眼干、眼痛、眼痒、异物感以及视物模糊发生率与Ⅱ组相比,差异均不具有统计学意义(P＞0.05);MGD组文化水平与NMGD组相比,差异没有统计学意义(P=0.382,＞0.05)。结论 首先,在40岁以下人群中,睫毛蠕形螨与MGD形成有一定相关性;而在60岁以上人群中,相较于其他影响因素,睫毛蠕形螨对MGD形成的作用并不显著,表明睫毛蠕形螨对MGD形成的影响主要体现在中青年时期,且随着年龄增长,二者之间的关联性进一步降低。另外,睫毛蠕形螨感染与MGD患者发生眼痛、眼干、眼痒、异物感以及视物模糊这些眼部症状和睑板腺分泌功能受损没有相关性。

Objective To investigate the correlation between eyelash Demodex infection and meibomian gland dysfunction (MGD) and to analyze the effect of eyelash Demodex infection on ocular surface symptoms and signs in patients with MGD. Methods Prospective cohort study. 47 patients with MGD diagnosed in the ophthalmology clinic of Guangzhou First People's Hospital from July 2018 to March 2019 were selected. The MGD patients were assigned to the MGD＜40 years old group (A₁ group, n=28) and MGD＞60 years old Group (B₁ group, n=19) according to the age. According to the Demodex test results, MGD patients were assigned to the Demodex-positive group (I group, n=22) and the Demodex-negative group (II group, n=25). At the same time, 49 patients without MGD or only with ametropia and vitreous opacity were selected and assigned to the NMGD＜40 years old group (A₂ group, n=30) and NMGD＞60 years old group (B₂ group, n=19) according to their age. The incidence of ocular symptoms (itchiness, pain, dryness, foreign body perception, and blurred vision), the number and rate of detection of eyelash Demodex, meibomian gland ejection score, meibomian gland secretion score, and Ocular Surface Disease Index (OSDI) were analyzed. Results The number of eyelash Demodex was (1.14±1.938) in MGD＜40 years old group (A₁ group) and (0.17±0.531) in NMGD＜40 years old group (A₂ group). The difference in the number of eyelash Demodex between these two groups was found to be statistically significant (P=0.003,＜0.05). The positive rate of eyelash Demodex was 43 % in MGD＜40 years old group (A1 group) and 10% in NMGD＜40 years old group (A₂ group). The difference in the positive rate of eyelash Demodex between these two groups was found to be statistically significant (P=0.006,＜0.05). The number of eyelash Demodex in MGD＞60 years old group (B₁ group) was (1.89±2.331) and in NMGD＞60 years old group (B₂ group) was (0.68±1.529). The difference in the number of eyelash Demodex between these two groups was not statistically significant(P>0.05). The positive rate of eyelash Demodex was 53 % in MGD＞60 years old group (A₁ group) and 21% in NMGD＞60 years old group (A₂ group). The difference in the positive rate of eyelash Demodex between these two groups was not statistically significant (P>0.05). The score of the meibomian gland secretion in the MGD with eyelash Demodex group (I Group) was (3.00±1.11) and in the MGD without eyelash Demodex group (II group) was (2.28±1.28). The difference in the score of the meibomian gland secretion between these two groups was found to be statistically significant (P=0.047<0.05). The differences of the OSDI score, the meibomian gland discharge ability score, the incidence rate of dry eye, eye pain, eye itching, foreign body sensation and blurred vision between these two groups were not statistically significant (P>0.05). The difference in the culture level between the MGD group and the NMGD group was not statistically significant (P=0.382, >0.05). Conclusion First, in the population under 40 years old, eyelash Demodex is correlated with MGD. Then in the population over 60 years old, the effect of eyelash Demodex on the formation of MGD compared with other influencing factors is not significant. The results indicated that the effect of eyelash Demodex was mainly reflected in the middle and young age, and the correlation between them was further reduced with the increase of age. In addition, in MGD patients, eyelash Demodex infection was not significantly correlated with the incidence of eye pain, eye dryness, eye itching, foreign body sensation, and blurred vision, as well as the degree of impairment of meibomian gland secretion function.

目的 应用斑点追踪显像定量评价阻塞性睡眠呼吸暂停综合征患者的左心房功能,并进行对比研究。方法 OSAS患者60例,根据睡眠呼吸暂停低通气指数(AHI)分为3组,轻度组,中度组,重度组,每组20人;另选择20名健康正常人作为正常对照组。采用二维斑点追踪成像技术测量各组左心房相关应变参数:收缩期应变(Ss),舒张早期应变(Se),舒张晚期应变(Sa),左心房收缩期应变率(SRs),左心房舒张早期应变率(SRe),左心房舒张晚期应变率(SRa),分析并比较各组间参数的差异性。结果 随着疾病严重程度的增加Ss、SRs、Se、SRe呈逐渐减低的趋势,而Sa、SRa先升高后减低,差异有统计学意义(P<0.05)。结论 应用斑点追踪成像技术可在OSAS患者发生左心房重构前检测出心房功能的变化。

Objective The left atrial function of patients with obstructive sleep apnea syndrome was quantitatively evaluated by speckle tracing imaging and compared. Methods Sixty patients with OSAS were divided into three groups according to the sleep apnea hypopnea index(AHI),including the mild group, the moderate group and the severe group, with 20 patients in each group. Another 20 healthy people were selected as the normal control group. Left atrial correlation strain parameters:systolic strain(Ss), early diastolic strain(Se), late diastolic strain(Sa), left atrial systolic strain rate(SRs), early diastolic strain rate(SRe), left atrium left atrium late diastolic strain rate(SRa) were measured by two dimensional speckle tracking imaging technology, and the differences of parameters between groups were compared. Results With the increase of disease severity, Ss, SRs, Se and SRe showed a trend of gradual decrease, while Sa and SRa increased first and then decreased, and the difference was statistically significant(P<0.05). Conclusion Changes in atrial function may be detected in OSAS patients prior to left atrial remodeling using speckle tracking imaging.

目的 运用三维斑点追踪成像(3D-STE)技术,检测系统性红斑狼疮(SLE)患者的左室收缩期峰值应变(S)和应变率(Sr)及舒张指数,探讨其评价 SLE 患者左室整体收缩及舒张功能的临床应用价值。方法 选择 30 例 SLE 患者(SLE 组)和 30 例正常人(对照组),分别对其进行二维超声心动图和3D-STI检查,获取心尖四腔、两腔、三腔及心尖长轴二维超声及M型超声切面,测量左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVEDs)、室间隔舒张末期厚度(IVSd)、室间隔收缩末期厚度(IVSs)、左心室后壁舒张末期厚度(LVPWd)、左心室后壁收缩末期厚度(LVPWs)、左心室射血分数(LVEF)、左心室缩短分数(LVFS)、每搏输出量(SV)、左室舒张末期容积(EDV)、收缩末期容积(ESV)、心输出量(CO)、球形指数(SPI)、左室舒张末期质量(LV EDmass)、左室收缩末期质量(LV ESmass)。应用3D-STI行心肌运动分析, 测量左心室整体纵向、圆周、径向及面积收缩期峰值应变(GLS、GCS、GRS、GAS),经胸采集四维全容积图像,应用公式计算各方向相应的舒张期前1/3点时的应变显像舒张指数(SI-DI),公式为(SI-DI=(A-B)/A×100%)。应用统计学分析上述指标在各组间的差异性及其之间的相关性。结果 SLE 组超声心动图的测量数值(LVEF、 LVFS、SV、EDV、CO、LV EDmass、LV ESmass)较对照组降低,差异有统计学意义(P＜0.05),(LVEDd、LVEDs、IVSd、IVSs、LVPWd、LVPWs、ESV、SPI) 与对照组比较, 差异亦均无统计学意义(P＞0.05)。SLE组左心室 GLS、GCS、GRS、GAS均较对照组减低, 差异均有统计学意义(P<0.05)。GAS诊断SLE的敏感度为93.3%,高于GLS(80%)、GCS(66.7%)、GRS(86.7%),GCS诊断SLE的特异度为(93.3%),高于GLS(86.7%)、GAS(86.7%)和GRS(73.3%);应用公式计算得出,SLE组左心室L-SI-DI、C-SI-DI、R-SI-DI 及A-SI-DI均低于正常对照组,差异均有统计学意义(P<0.05);ROC 曲线显示C-SI-DI敏感度(93.3%)及L-SI-DI敏感度(86.7%)高于R-SI-DI(80.0%)、A-SI-DI(80.0%);A-SI-DI特异度(93.3%)及R-SI-DI特异度(93.3%)高于L-SI-DI(73.3%)、C-SI-DI(73.3%)。结论 SLE 患者左室总体收缩及舒张功能减低,4D-STI超声斑点追踪技术可早期检测 SLE 患者左心室收缩及舒张功能的异常。

Objective To detect left ventricular systolic peak strain(S), strain rate(Sr) and diastolic index in patients with systemic lupus erythematosus(SLE) by three-dimensional speckle tracking imaging(3D-STE), and to evaluate the left ventricular total in SLE patients and clinical application value of systolic and diastolic function. Methods Thirty patients with SLE(SLE group) and 30 normal controls(control group) were enrolled. Two-dimensional echocardiography and 4D-STI were performed to obtain sections of apical four-chamber, two-chamber, three-chamber and apical long axis of ultrasound and m-mode ultrasound. To measure left ventricular end-diastolic diameter(LVEDd), left ventricular end-systolic diameter(LVEDs), ventricular septal end-diastolic thickness(IVSd), ventricular septal end-systolic thickness(IVSs), left ventricular posterior wall diastolic end-stage thickness(LVPWd), left ventricular posterior wall end-systolic thickness(LVPWs), left ventricular ejection fraction(LVEF), left ventricular shortening fraction(LVFS), stroke volume(SV), left ventricular end-diastolic volume(EDV), end-systolic volume(ESV), cardiac output(CO), spherical index(SPI), left ventricular end-diastolic mass(LV EDmass), left ventricular end-systolic mass(LV ESmass). 4D-STI myocardial motion analysis, the total longitudinal, circumferential, and radial and area systolic peak strains(GLS, GCS, GRS, GAS) of the left ventricle were measured, and the four-dimensional full-volume images were collected through the thoracic, and the formula was used to calculate the first 1/3 of the diastolic phase in each direction. The formula of strain imaging diastolic index(SI-DI) is(SI-DI=(AB)/A×100%). Statistical analysis was used to analyze the differences between the above indicators and the correlation between the groups. Results The measured values of two-dimensional echocardiography(LVEF, LVFS, SV, EDV, CO, LV EDmass, LV ESmass) in the SLE group were lower than those in the control group, and the difference was statistically significant(P＜0.05). In LVEDd, LVEDs, IVSd, IVSs, LVPWd, LVPWs, SPI, there were no significant differences compared with that of control group(P＞0.05). The left ventricular GLS, GCS, GRS, and GAS in the SLE group were lower than those in the control group. The differences were statistically significant(P<0.05). The sensitivity of GAS in the diagnosis of SLE was 93.3%, higher than GLS(80%), GCS(66.7%), and GRS(86.7%). The specificity of GCS for the diagnosis of SLE was(93.3%), higher than GLS(86.7%), GAS(86.7%) and GRS(73.3%). The left ventricle L-SI-DI, C-SI-DI, in the SLE group was calculated by the formula. R-SI-DI and A-SI-DI were lower than the normal control group, the difference was statistically significant(P<0.05);the ROC curve showed C-SI-DI sensitivity(93.3%) and L-SI-DI sensitivity(86.7%) was higher than R-SI-DI(80.0%), A-SI-DI(80.0%);A-SI-DI specificity(93.3%) and R-SI-DI specificity(93.3%) was higher than L-SI-DI(73.3%) and C-SI-DI(73.3%). Conclusion Total left ventricular systolic and diastolic function in patients with SLE are reduced. 4D-STI ultrasound speckle tracking technique can detect left ventricular systolic and diastolic dysfunction in patients with SLE.