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目的:探讨心肌做功指数(MPI)评价类风湿性关节炎(RA)患者亚临床右心室功能损害的应用价值。方法:选取常规超声心动图正常的RA患者(RA组)25例及正常志愿者(对照组)25例,常规超声测定右心室舒张末内径、右心房内径、肺动脉内径、E峰、A峰及E峰减速时间,计算MPI,有三尖瓣反流者评估肺动脉收缩压;组织多普勒成像测定三尖瓣环S′、E′、A′,计算E′/A′、E/E′与MPI′。结果:两组常规超声与组织多普勒参数均差异无统计学意义;RA组MPI明显增大(P<0.01),MPI′差异与对照组无统计学意义;MPI与病程呈正相关(r=0.319,P=0.033),与年龄无关。结论:常规超声正常的RA患者可出现亚临床右心室功能损伤,表现为MPI明显增大;MPI是评价RA患者右心室功能的有效手段。
Objective: To investigate the value of myocardial work index (MPI) in assessing subclinical right ventricular dysfunction in patients with rheumatoid arthritis (RA). Methods: Totally 25 RA patients (RA group) and 25 healthy volunteers (control group) with normal echocardiography were selected. The diastolic diameter, right atrial diameter, pulmonary artery diameter, E peak deceleration time, calculate MPI, tricuspid regurgitation were evaluated pulmonary artery systolic pressure; Tissue Doppler imaging of tricuspid annulus S ’, E’, A ’, calculate E’ / A ’, E / E’ and MPI ’. Results: There was no significant difference between conventional ultrasound and tissue Doppler parameters in both groups; MPI in RA group was significantly increased (P <0.01), while MPI ’was not significantly different from that in control group. MPI was positively correlated with duration of disease (r = 0.319, P = 0.033), regardless of age. CONCLUSION: Subclinical right ventricular dysfunction may occur in patients with normal ultrasound and normal RA, and MPI is obviously increased. MPI is an effective means to evaluate right ventricular function in patients with RA.