容量负荷变化对组织多普勒评价左心室舒张功能的影响  

Effects of the Change of Preload to Left Ventricular Diastolic Function by Tissue Doppler Imaging

作　　者：陈新颜[1] 鄢巨振[2] 高秀玲[1] 

机构地区：[1]苏州大学附属第四医院心超室,江苏无锡214062 [2]杭州师范大学附属医院肾内科,浙江杭州310016

出　　处：《苏州大学学报（医学版）》2010年第5期1025-1027,1048,共4页Suzhou University Journal of Medical Science

摘　　要：目的探讨容量负荷变化对组织多普勒成像技术(TDI)检测左心室舒张功能参数的影响。方法左心室收缩功能正常的88例肾功能衰竭患者按透析量分为3组:透析量<2000ml(组1)33例,透析量为2000ml～3000ml(组2)30例,透析量>3000ml(组3)25例,运用脉冲多普勒测定3组患者舒张期二尖瓣口血流频谱(E、A),脉冲型组织多普勒技术(PW-TDI)测量左室二尖瓣环四个位点(间隔、侧壁、前壁、下壁)的平均收缩期峰值速度(Sa)、舒张早期峰值速度(Ea)和舒张晚期峰值速度(Aa)。对3组透析前、后各值对比分析。结果组1的TDI各参数透析后无显著改变(P>0.05),组2、组3患者透析后除Sa外各参数值显著下降(P<0.05)。结论 TDI技术评价尿毒症透析患者的左心室舒张功能时,当透析量较少时其结果较可靠,但随透析量增大则可能受容量负荷的影响。二尖瓣环收缩期运动速度Sa对容量负荷的变化无依赖性。Objective To explore the effects of the change of preload to the left ventricular diastic function by tissue Doppler imaging（ TDI） . Methods Eighty-eight patients with uremia receiving regular hemodialysis（ H/D） were separated by the amount of body fluid removed during H/D procedure： group 1： 2 000 ml,group 2： 2 000 ～ 3 000 ml,group 3： 3 000 ml. The diastic trans-mitral velocity（ E,A） , the mean of mitral annulus systolic peak velocities,early diastolic peak velocities and later diastolic peak velocities of mitral annulus （ Mean Sa,Mean Ea,Mean Aa） were obtained immediately before and after H/ D. Results For group 1,the change of TDI parameters showed insignificant change（ P 0. 05） ; for group 2 and group 3,the change of all diastolic parameters showed stastistically significant difference except mean Sa（ P 0. 05） . Conclusions In uremic patients with normal left ventricular systolic function,when the amount removed during H/D is less than 2 000 ml ,the parameters of TDI is steady,when the amount removed during H/D is more than 2 000 ml ,diastolic phase mitral annulus Doppler tissue velocities are not totally independent preloadedly. For systolic phase mitral annulus Doppler tissue velocity index（ Sa） ,it is independent preloadedly.

关 键 词：组织多普勒成像 透析 容量负荷 

分 类 号：R445.1[医药卫生—影像医学与核医学] R540.45[医药卫生—诊断学]