三维定量分析与自动心肌运动定量技术评估慢性肾脏病患者左心室收缩功能的价值  

Superiority of three-dimensional quantitative analysis technique and automatic cardiac motion quantification technique in evaluating left ventricular systolic function in patients with chronic kidney disease

作　　者：符梦竹[1] 杨俊华 李杏 Fu Mengzhu;Yang Junhua;Li Xing(Department of Echocardiography,Wuxi No.2 People's Hospital,Wuxi 214000,China)

机构地区：[1]无锡市第二人民医院心功能室,无锡214000

出　　处：《中华医学杂志》2019年第4期312-317,共6页National Medical Journal of China

摘　　要：目的探讨三维定量分析技术(3DQA)与自动心肌运动定量技术(aCMQ)评估不同分期慢性肾脏病(CKD)患者左心室收缩功能的价值。方法选取2016年6月至2017年12月入住无锡市第二人民医院肾内科的127例CKD患者,男65例,女62例,年龄(50.99±11.05)岁。分为3组,A组(CKD1-2期44例)、B组(CKD3期38例)及C组(CKD4-5期45例)。同期选取年龄、性别匹配的50名健康人作为对照组。运用aCMQ和3DQA分别获取4组研究对象的左心室各节段及整体长轴应变(GLS)、左心室各节段及整体三维位移,并进行比较分析。结果左心室各节段长轴应变:与对照组比较,A组有5/17节段、B组有10/17节段、C组所有节段均减低(均P<0.05)。左心室各节段三维位移:与对照组比较,A组有6/17节段、B组有12/17节段、C组所有节段均减低(均P<0.05)。左心室整体长轴应变:与对照组比较,A组差异无统计学意义,B组、C组GLS绝对值[(19.82±3.62)%、(16.62±5.48)%比(21.98±4.32)%]均减低(均P<0.05)。左心室整体三维位移:与对照组比较,A组、B组、C组整体三维位移值[(6.24±0.51)mm、(5.54±0.29)mm、(4.62±0.55)mm比(7.11±0.51)mm]均减低(均P<0.05)。结论3DQA与aCMQ均能早期发现CKD患者左心室收缩功能的异常,且3DQA的左心室整体三维位移参数比aCMQ的左心室整体长轴应变参数更敏感。Objective To investigate the value of three-dimensional quantitative analysis (3DQA) and automatic cardiac motion quantification (aCMQ) in evaluating the left ventricular systolic function in patients with different stages of chronic kidney disease (CKD). Methods A total of 127 cases of CKD patients between June 2016 and December 2017 who were admitted to Department of Nephrology of Wuxi No.2 People′s Hospital were divided into three groups: Group A (44 cases in CKD stage 1 and 2), Group B (38 cases in CKD stage 3) and Group C (45 cases in CKD stage 4 and 5). Another 50 age and sex matched normal controls were selected during the same period. The left ventricular segments and global longitudinal strain (GLS), left ventricular segments and global three-dimensional displacement (3DD) obtained by aCMQ and 3DQA techniques were compared and analyzed. Results Compared with the control group, as for the longitudinal strain (LS) of each segment of left ventricular 5 (17 in all) segments in Group A, 10 segments in Group B and all segments in Group C decreased (P<0.05). As for the 3DD of each segment of left ventricular, 6 segments in Group A, 12 segments in Group B and all segments in group C decreased (P<0.05). As for the GLS, there was no statistically significant difference in group A, however, absolute value of GLS in group B and C [(19.82±3.62)%, (16.62±5.48)% vs (21.98±4.32)%] decreased statistically significantly (both P<0.05). As for the left ventricular global 3DD, the global 3DD of group A, group B and group C [(6.24±0.51) mm, (5.54±0.29) mm, (4.62±0.55) mm vs (7.11±0.51) mm] decreased (all P<0.05). Conclusions Three-dimensional quantitative analysis and automatic cardiac motion quantification can detect the abnormality of left ventricular systolic function in patients with chronic kidney disease at an early stage. And the global 3DD of left ventricle of 3DQA is more sensitive than the global longitudinal strain of left ventricle of aCMQ.

关 键 词：超声心动描记术 三维 慢性肾脏病 心室功能 左 

分 类 号：R692[医药卫生—泌尿科学] R445.1[医药卫生—外科学]