三维斑点追踪技术评价慢性肾功能衰竭患者左心室整体应变  

Assessment of global left ventricular strain by three-dimensional speckle tracking imaging in patients with chronic renal failure

作　　者：柯茜茜[1] 黎春雷[1] 王晨阳[1] 金丹[1] 邓又斌[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院超声影像科,武汉430030

出　　处：《中华超声影像学杂志》2014年第12期1030-1034,共5页Chinese Journal of Ultrasonography

摘　　要：目的 应用三维斑点追踪（3D-STI）技术评价慢性肾功能衰竭（CRF）患者的左室整体应变,并探讨左室整体峰值应变与左室射血分数（LVEF）之间的关系.方法 选取CRF患者47例（肾衰竭期22例,尿毒症期透析前患者25例）,以及健康对照者20例.应用三维斑点追踪技术测量并计算左室整体收缩期纵向峰值应变（GPSL）、整体面积峰值应变（GPSA）、整体径向峰值应变（GPSR）.采用Pearson相关分析法分析CRF患者GPSL、GPSA、GPSR与LVEF的相关性.结果 健康对照组、肾衰竭组、尿毒症组GPSL、GPSA、GPSR的差异均有统计学意义（F=13.28、4.65、4.68,P＜0.01）.两两比较中,尿毒症组GPSL、GPSA、GPSR与正常对照组相比均减低,差异有统计学意义（q=7.48、4.19、4.72,P均＜0.01）;肾衰竭组GPSL较正常对照组减低,差异有统计学意义（q=4.9,P＜0.01）.Pearson相关分析表明CRF患者GPSL、GPSA、GPSR与LVEF均具有良好的相关性（r=-0.679、-0.781、0.719,P＜0.01）.结论 对于CFR患者,左室整体峰值应变能反映左室收缩期的射血功能,且整体纵向峰值应变能较敏感地识别左室收缩功能受损.Objective To evaluate global left ventricular（LV） strain of patients with chronic renal failure（CRF） by three-dimensional speckle tracking imaging（3D-STI） and discuss the possible association between global peak strain and ejection fraction of LV.Methods The study includes 22 patients in the renal failure period,25 patients with uremia （pre-dialysis）,and 20 healthy controls.Global peak longitudinal strain （GPSL）,global peak area strain（GPSA） and global peak radial strain（GPSR） were measured by 3D-STI.Then possible association between GPSL,GPSA,GPSR and LVEF were discussed by the Pearson correlation analysis.Results The GPSL,GPSA,GPSR were statistically different in the control group,patients in the renal failure period and patients with uremia.There were significant differences between groups（F =13.28,4.65,4.68,P ＜ 0.01） as following,all of GPSL,GPSA,GPSR were lower in uremia group compared with control group [q =7.48（GPSL）,4.19（GPSA）,4.72（GPSR）,P ＜0.01],GPSL was lower in renal failure group compared with control group [q =4.9 （GPSL）,P ＜0.01].The Pearson correlation analysis revealed GPSL,GPSA,GPSR were strongly associated with LVEF（r =-0.679,-0.781,0.719,P ＜0.01）.Conclusions In patients with CRF,the global peak strain can reveal the systolic function of left ventricle and the global peak longitudinal strain can recognize systolic dysfunction more sensitively.

关 键 词：超声心动描记术 三维 肾功能衰竭 慢性 心室功能 左 斑点追踪显像 

分 类 号：R540.45[医药卫生—心血管疾病] R692.5[医药卫生—内科学]