实时三维超声心动图定量评价慢性肾功能衰竭患者左心室收缩同步性的研究  

Quantitative assessment of left ventricular systolic synchrony in patients with chronic renal failure using real-time three-dimensional echocardiography

作　　者：纪淑姣[1] 袁建军[1] 魏常华[1,2] 

机构地区：[1]河南省人民医院超声科,郑州450003 [2]郑州大学第一附属医院

出　　处：《中华医学超声杂志（电子版）》2008年第2期26-29,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨实时三维超声心动图在评价慢性肾功能衰竭(CRF)患者左心室收缩同步性中的应用价值。方法对30例CRF患者和25例正常对照组先行常规超声检查,获取M型左心室射血分数(M-EF)、左心室舒张末期内径(LVIDd)、左心室室间隔厚度(IVSD)、左心室后壁厚度(LVPWD);再采用三维超声心动图(RT-3DE)获取左心室全容积图像,并采用Qlab分析软件计算左心室17节段达到收缩期最小容积点时间(Tmsv)的标准差(Tmsv16-SD、Tmsv12-SD和Tmsv6-SD)及最大时间差(Tmsv16-Dif、Tmsv12-Dif和Tmsv6-Dif),对标准差及最大时间差行心率校正,同时采集左心室舒张末期容积(LVEDV)、收缩末期容积(LVESV)、射血分数(LVEF)和心率(HR)。结果一般情况比较显示,CRF组HR、LVIDd、IVSd、LVPWd及LVESV均大于正常组(P<0.05或P<0.01),LVEF小于正常组(P<0.05);时间-容积曲线同步性收缩参数比较显示,Tmsv6-SD及Tmsv6-Dif两组间差异无统计学意义(P>0.05),余参数CRF组均大于正常组(P<0.01或P<0.05)。结论实时三维超声心动图能在同一心动周期内比较左心室各节段收缩的同步性,为临床评价CRF患者左心室内收缩不同步及心功能提供了简便、直观、无创性的新方法。Objective To quantitatively evaluate the left ventricular systolic synchrony in patients with chronic renal failure （ CRF ） by real - time three - dimensional echocardiography （ RT - 3 DE ） . Methods Thirty patients with CRF and twenty-five normal subjects were enrolled in this study. The M-mode ejection fraction （M-EF）, left ventr/cular end diastolic internal diameter （LVIDd）, interventricular septum diameter （ IVSd）, left ventricular posterior wall diameter （LVPWd） were obtained on two-dimension. The global and regional volume-time curves were obtained on three -dimensional. The end diastolic volume （LVEDV）, end systolic volume （LVESV） and ejection fraction （LVEF） of left ventricule, the time to minimal systolic volume （ Tmsv ） of 16,12,6-segmental standard deviation （ Tmsv 16, 12, 6-SD）, maximal difference （ Tmsv 16, 12, 6-Dif） were derived from Qlab software. The above parameters as a percentage of the cardiac cycle with different heart rates between patients were also calculated from the Qlab software, which were Tmsv16, 12, 6-SD% and Tmsv16, 12, 6-Dif %, rspectively. Results The indices of HR, LVIDd, IVSd, LVPWd and LVESV were significantly higher while LVEF was significantly lower in the CRF group than those of the control group （P 〈0. 05 or P 〈0.01 ） ; The indices of systolic asynchrony of Tmsv16,12-SD%, Tmsv16, 12-Dif, Tmsv16 ,12 ,6-SD/R-R% ,Tmsv16,12,6-Dif/R-R% were significantly larger in the CRF group than those of the control group （ P 〈 0.05 or P 〈 0.01 ）. Conclusions RT-3 DE provides a simple, intuitional and noninvasive approach to assess the systolic synchrony of all the LV segments simultaneously and LVEF in patients with chronic renal failure.

关 键 词：三维超声心动描记术 慢性肾功能衰竭 左心室功能障碍 

分 类 号：R445.1[医药卫生—影像医学与核医学] R692.5[医药卫生—诊断学]