二维斑点追踪技术评价伴发高血压的慢性肾衰竭患者肾功能失代偿期的左心功能  

Evaluation of the Left Heart Function in Patients with Chronic Renal Failure at Decompensation Stage Complicated with Hypertension by Two-Dimensional Speckle Tracking Imaging

作　　者：段文姣[1] 刘蓉[1] 赵秋霞 Duan Wenjiao;Liu Rong;Zhao Qiuxia(The First College of Clinical Medical Science,China Three Gorges University & Yichang Central People's Hospital,Yichang,Hubei 443003,China)

机构地区：[1]三峡大学第一临床医学院&宜昌市中心人民医院超声科,湖北省宜昌市443003

出　　处：《中国超声医学杂志》2019年第1期18-21,共4页Chinese Journal of Ultrasound in Medicine

基　　金：2017年宜昌市医疗卫生科研项目(No.A17-301-06)

摘　　要：目的应用二维斑点追踪技术评价伴发高血压的慢性肾衰竭患者肾功能失代偿期左心功能的改变。方法选取27例伴发高血压的慢性肾衰竭肾功能失代偿期(血肌酐水平:186～442μmol/L)患者,高血压组26例及健康组25例,二维斑点追踪技术测量左室各节段纵向应变、左室整体纵向应变(LV GLS)及左房整体应变(LAGS)。结果 (1)与健康组比较,高血压组、伴发高血压的慢性肾衰竭患者肾功能失代偿期组左室部分节段纵向应变减低(P<0.05),而LV GLS无明显改变(P>0.05);高血压组与伴发高血压的慢性肾衰竭患者肾功能失代偿期两组间左室各节段纵向应变、LV GLS均无明显差异(P>0.05)。(2)与健康组、高血压组比较,伴发高血压的慢性肾衰竭患者肾功能失代偿期组LAGS明显减低(P<0.05)。结论伴发高血压的慢性肾衰竭患者肾功能失代偿期LAGS明显减低,提示LAGS在检测伴发高血压的慢性肾衰竭患者肾功能失代偿期心肌受损更为敏感。Objective To evaluate the left heart function in patients with chronic renal failure(CRF)at decompensation stage complicated with hypertension by two-dimensional speckle tracking imaging(2D-STI).MethodsTwenty-seven patients with CRF at decompensation stage(estimated serum creatinine:186-442μmol/L)complicated with hypertension,twenty-six patients with hypertension and twenty-five healthy control subjects were prospectively recruited.The left ventricular segmental longitudinal strain,the left ventricular global longitudinal strain(LV GLS)and left atrial global strain(LAGS)were measured by 2D-STI.Results(1)Compared with healthy control group,the longitudinal strain of some segments significantly decreased in CRF at decompensation stage complicated with hypertension group and in hypertension group(P<0.05),while the LV GLS had no significant difference(P>0.05).Neither the longitudinal strain of each segment nor the LV GLS had significant difference(P>0.05)between hypertension group and CRF at decompensation stage complicated with hypertension group.(2)Compared with healthy control group and hypertension group,the LAGS significantly decreased in CRF at decompensation stage complicated with hypertension group(P<0.05).Conclusions The LAGS significantly decreased in CRF at decompensation stage complicated with hypertension group,indicating that LAGS is more sensitive to detect myocardial involvement in patients with CRF at decompensation stage complicated with hypertension.

关 键 词：慢性肾衰竭 超声 二维斑点追踪技术 

分 类 号：R544.1[医药卫生—心血管疾病] R692.5[医药卫生—内科学] R445.1[医药卫生—临床医学]