The Clinical Research Of Carotid Arterial Structure And Function In Patients With Systemic Lupus Erythematosus By Echo-tracking Technique

Background:Systemic lupus erythematosus (SLE) is a more common clinical autoimmune disease which effects multiple organ system. SLE patients with cardio-vascular disease is the most common course of late complications and the main cause of death. Study confirmed that atherosclerosis is the most common pathological basis of cardiovascular disease, so early detection of atherosclerotic disease is important as sub-clinical lesions.Purpose:To observe the morphological change characteristics of carotid artery by color doppler ultrasound detecting carotid artery IMT and blood flow parameters with SLE patients; To explore the clinical value of early diagnosis of atherosclerosis in SLE by application of vascular echo tracking technique and quantitative detection elasticity functional changes of carotid artery with SLE patients.Materials and Methods:1. Selected 50 rheumatology SLE inpatients in March 2009～November 2009 of the Second Hospital of Shanxi Medical University,which meet the 1997 American Rheumatism Association diagnostic criteria for SLE, excluding angina pectoris, myocardial infarction and cerebral vascular accident patients. The patients are divided into SLE1 group (history of≤1 year), and SLE2 group (history of>a year) based course, SLE1 group of 25 cases, female 24 cases,1 case men, aged 12 to 48 years with an average (30.56±10.33) years, duration 10 day～1 year on average (2.0±4.0) months; SLE2 group of 25 cases, female 24 cases,1 case men, aged 18 to 55 years with an average (32.20±9.64) years, duration of more than a year to 25 years, the average (6.0±11.5) years. The normal control group,25 cases, female 24 cases,1 case men, aged 12 to 55 years old, with an average (33.68±11.39) years, which were normal healthy people for the physical examination and biochemical tests.2. Blood pressure measurement:Taking the subjects right upper limb blood pressure with the mercury sphygmomanometer, who are supin resting state. The blood pressure was measured three times, each time interval measured 10min, taking the average blood pressure of three times.3. Carotid artery ultrasound:Application with ET technology and built-in digital image management system (e-DMS) of ALOKAα10 color Doppler ultrasonic diagnostic apparatus, the probe frequency of 7.5～13.0MHz, link synchronization electrocardiogram.(1) Detect the common carotid artery structure and blood flow parameters with color Doppler ultrasonography, measuring three times averaged.(2) Collecting a clear two-dimensional image in ET mode, select the sampling area from the bifurcation of the common carotid artery proximal end of 2.0cm. To regulate M-sampling lines, so that the vertical and the common carotid artery wall in order to obtain the best possible image and maximum diameter of blood vessels. In the B/M mode, tracking the motion of anterior and posterior vessels wall at systolic and diastolic in real-time and tracing in mind,that automatically calculates the vessel diameter changes in cardiac cycle, and the form of a curve shows the result.We access the common carotid artery diameter curves more than 12 consecutive cardiac cycle and save it. Enter systolic and diastolic blood pressure, select 5 to 8 of satisfaction cardiac cycle image input e-DMS-line or off-line analysis. All data were measured three times and averaged. Image and data was stored by hard disk and CD-ROM format. Ultrasonic testing was completed by a longevity professional doctor.4. Statistical Analysis:Application SPSS 13.0 Statistical Package for the right data for statistical analysis.Results:1. Color Doppler ultrasound test results:carotid artery systolic and diastolic diameter of three groups was no significant difference (P>0.05). SLE1 group and the control group, IMT was no significant difference (P>0.05). SLE2 group and SLE1 group,IMT was a significant difference (P＜0.01). Carotid artery PSV,MDV and RI among the three groups were a significant difference (P＜0.01).2. Vascular echo tracking test results:AI of three groups'carotid artery was no significant difference. Ep,β, PWVP index of SLE1 group and SLE2 group are higher than the control group,AC index lower; Ep,β, PWVβindex of SLE2 Group compared with SLE1 group increased, AC index decreased.Conclusion:The application of ET technology can diagnose quantitativly early atherosclerosis, complications of cardiovascular disease with SLE, and has a high clinical value.