Ultrasonic Evaluation Of Right Ventricular Systolic Function And Analysis Of Risk Factors In Patients With Primary Sjogren’s Syndrome Complicated With Pulmonary Hypertension

Objective:Echocardiography was used to screen patients with p SS-PAH and p SS-N-PAH.The right ventricular function parameters and clinical indicators of the two groups were compared,and the risk factors of the indicators significantly related to PAH were analyzed.Methods:60 patients with p SS diagnosed and treated by the Rheumatology Department of the Second Hospital of Shanxi Medical University from December 2021 to December 2022 were selected as the research objects,and the right ventricular end diastolic diameter(RVDd),right atrial area at the end of contraction,right ventricular area change rate(FAC),diameter of main pulmonary artery,pulmonary valve orifice return velocity at the early diastolic stage,inferior vena cava diameter,inferior vena cava collapse rate,tricuspid annular systolic displacement(TAPSE)Right ventricular myocardial work index(RVMPI),right ventricular free wall S’,pulmonary artery systolic pressure(PASP);The clinical data of all patients were collected at the same time.The patients were divided into p SS-PAH group and p SS-N-PAH group according to the PASP value.The above parameters of the two groups were compared,and the indicators significantly related to PAH were analyzed for risk factors.Results:1.Comparison of general clinical data: There was no significant difference between the two groups in terms of gender ratio and age distribution(P>0.05).2.Comparison of ultrasonic parameters and clinical indicators: The RVDd,right atrial area,pulmonary artery diameter,inferior vena cava diameter,RVMPI,and early diastolic pulmonary regurgitation velocity in the p SS-PAH group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05);FAC,TAPSE,and right ventricular free wall S’ were significantly lower in the control group than in the control group(P<0.05).The CRP in the p SS-PAH group was significantly higher than that in the control group,with SIL-2R,IL-4,IL-10,Ig A,and Ig G being mostly positive(P<0.05).The total T lymphocytes,leukocyte levels,lymphocyte percentage,complement C3,C4 in the p SS-PAH group were significantly lower than those in the control group(P<0.05).3.Correlation and regression:There was a negative correlation between PASP and the percentage of total T lymphocytes and lymphocytes in the two groups.PASP was positively correlated with CRP,pulmonary interstitial fibrosis,Ig G,IL-4,and pericardial effusion,of which CRP had the strongest correlation with PASP.Logistic regression showed that IL-4 positive and CRP increase were risk factors for PAH,and the increase of lymphocyte percentage was protective factor for PAH.Conclusion:Echocardiographic detection of TAPSE,FAC,RVMPI,right atrial area at end systole,inferior vena cava collapse rate,right ventricular free wall S’ and other parameters can better evaluate the early changes of right ventricular function in p SS patients.For p SS patients whose CRP,IL-4 and lymphocyte percentage levels change,early detection of right heart function and pulmonary artery pressure can effectively prevent the occurrence of malignant cardiovascular events.