实时三维超声心动图定量评价腹膜透析治疗对尿毒症患者左心功能疗效的研究  

Evaluation the Therapeutic Efficacy of Left Ventricular Systolic Function of Uremia Treated with Peritoneal Dialysis Using Real-time Three-dimensional Echocardiography

作　　者：朱法望[1] 郑哲岚[3] 童孟立[2] 潘农[1] 张竹君[1] 王灵燕[1] 

机构地区：[1]杭州市中医院,暨浙江中医药大学附属广兴医院超声科,杭州市310007 [2]杭州市中医院,暨浙江中医药大学附属广兴医院肾内科,杭州市310007 [3]浙江大学医学院附属第一医院超声科

出　　处：《中国超声医学杂志》2012年第12期1089-1093,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨实时三维超声心动图(RT-3DE)定量评价腹膜透析治疗对尿毒症患者左心功能的疗效。方法应用节段运动幅度牛眼图对47例尿毒症患者腹膜透析前后的左室代偿运动节段进行定量分析,根据牛眼图上的色彩的分布计算代偿运动节段的百分比(PCS),并计算左室17节段的最大运动幅度(Emax)、最小运动幅度(Emin)、平均运动幅度(Eavg)、左室节段运动幅度离散度,并和30例对照组对比分析。结果 (1)腹膜透析治疗后,左室射血分数(三维测量计算法,3D-EF)、Eavg、Emax、Emin、PCS增加,达峰时间及达峰时间标准差下降,差异具有统计学意义(P<0.05),但和对照组比较,PCS、Eavg、Emax、Emin、达峰时间及达峰时间标准差仍存在差异,具有统计学意义(P<0.05),而3D-EF差异不具有统计学意义(P>0.05);(2)以5 mm为阈值,腹膜透析治疗前,低幅运动节段不少于2节段和5节段(相当于17节段的10%和30%)的发生率分别为100%(47/47)、44.7%(21/47),而腹膜透析后分别为27.7%(13/47)、8.5%(4/47),而对照组没有1例低幅运动节段大于2节段的。结论 RT-3DE提供了直观且简便的观察手段,能较好地评价腹膜透析治疗尿毒症患者左心功能疗效。Objective To evaluate the therapeutic efficacy of the left ventricular systolic function of uremia trea- ted with peritoneal dialysis using real time three-dimensional echocardiography （RT-3DE）. Methods Quantitative a nalysis of left ventricular segmental function was made in 47 uremia patients and 30 control individuals by RT 3DE il- lustration of the bull eye. Percentage of compensated segments （PCS） was determined accoding to the segmental distri- bution by different color from RT-3DE illustration of the bull eye. Maximal excursion （Emax）, minimal excursion （Emin）, average excursion （Eavg）, standard difference of excursion, dispersion of excursion and 3D-EF were calcu lated. Results （1） After peritoneal dialysis, the 3D-EF, Eavg, Emax, Emin and PCS were greater, but the time to peak systolic velocity （T-psv） and standard deviation of Tpsv were lower（P〈0.05）. Eavg, Emax, Emin and PCS were greater, but T-psv and standard deviation of T-psv were lower than those in controls（P〈0.05）, but no signifi- cant differences in 3D-EF（P〉0.05）. （2） 5 mm to thresholds, pre-treatment of peritoneal dialysis, low amplitude mo- tion segment of not less than 2 segments and 5 segments （equivalent to paragraph 17 of the 10% and 30%） the inci dence was 100% （47/47）, 44.70/00 （21/47）, and after peritoneal dialysis were 27.70/00 （13/47）, 8.5% （4/47）, while the control group, no one case of low amplitude motion segment more than 2 segments. Conclusions RT-3DE provides intuitive and easy means of cardiac function observation, and can better evaluate therapeutic efficacy of the left ventric- ular systolic function of uremia treated with peritoneal dialysis.

关 键 词：超声心动描记述 实时三维 尿毒症 肾透析 心功能 左 

分 类 号：R540.45[医药卫生—心血管疾病]