双多普勒成像技术同步测量E/e’评估尿毒症患者右室舒张功能  

Evaluation on the right ventricular diastolic function in uremia patients with E/e'using dual-Doppler detection simultaneously

作　　者：刘敏[1,2] 梁婷[1] 张晓玲[1] 王芳[1] 刘佳霓[1] 唐红[1] 

机构地区：[1]四川大学华西医院心内科,成都市610041 [2]成都市第一人民医院心内科

出　　处：《临床超声医学杂志》2014年第7期454-457,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨双多普勒成像技术同步测量E/e’评估左室射血分数正常的尿毒症患者右室舒张功能的价值。方法行动-静脉造瘘术后规律血液透析,且左室射血分数正常的尿毒症患者40例（病例组）和38例健康志愿者（对照组）为研究对象,采用双多普勒成像技术同步获取其三尖瓣血流频谱和三尖瓣环运动频谱,测量三尖瓣舒张早晚期血流峰值速度（E、A）,三尖瓣环收缩期运动峰值速度（s’）及舒张早晚期运动峰值速度（e’、a’）,计算E/e’。结果与对照组比较,病例组E/e’升高,E/A和e’/a’降低,等容舒张时间延长,差异有统计学意义（P〈0.05）。病例组E/e’与e’/a’值呈负相关（r=-0.444,P=0.004）。Bland-Altman分析显示双多普勒模式较传统多普勒模式测量E/e’重复性更佳[（-1.46-1.74）vs.（-0.72-0.53）]。结论双多普勒成像技术测量三尖瓣E/e’可用于评估左室射血分数正常的尿毒症患者右室舒张功能,较传统多普勒模式测量结果精确,重复性好。Objective To evaluate the fight ventricular diastolic function in uremia patients with normal left ventricular ejection fraction（LVEF） with E/e＇ measured simultaneously using Dual-Doppler.Methods A total of 40 uremia patients with normal LVEF were enrolled as uremia group, with hemodialyss byi artificial arteriovenous fistula regularly, and 38 healthy volunteers were in enrolled the control group.The spectrum of the transtricuspid flow and tricuspid annular in right ventricular lateral wall were acquired in apical four chamber view by Dual-Doppler modality in both groups.Doppler velocities of the transtricuspid flow （ E, A ）, tissue Doppler velocities of the tricuspid annulus （ s＇ , e＇, a＇ ） were measured, the E/e＇ was calculated.Results Compared with control group,E/e＇ was higher in uremia group,while the E/A and e＇/a＇ were descended, isovolumic relaxation time was delayed（P 〈 0.05 ）.The E/e＇ was negatively correlated with e＇/a＇ （r=-0.444,/）=-0.004 ）, Bland-Airman showed conventional E/e＇has poor reproducibility,while the simultaneous E/e＇ measured using Dual-Doppler has better reproducibility [ （-1.46-1.74） vs. （-0.72-0.53） ].Conelusion The simultaneous E/e＇ measured using Dual-Doppler is valuable for evaluating right ventricular diastolic function in uremia patients with normal LVEF.

关 键 词：超声心动描记术 双多普勒成像 尿毒症 三尖瓣E e’ 舒张功能 右室 

分 类 号：R692.5[医药卫生—泌尿科学]