实时三维超声心动图分析尿毒症血液透析患者左心室收缩同步性特征  

Evaluation of Left Ventricular Synchrony in Uremic Patients Underwent Hemodialysis by Real-time Three-dimensional Echocardiography

作　　者：张群英[1] 龚兰[1] 张强[1] 曹乐[1] 彭家清[2] 张克凯[2] 邢天柱[2] 

机构地区：[1]荆州市中心医院超声科,434020 [2]荆州市中心医院肾内科,434020

出　　处：《医学研究杂志》2015年第11期140-143,共4页Journal of Medical Research

摘　　要：目的利用实时三维超声心动图（RT-3DE）探讨尿毒症血液透析患者左心室机械运动同步性的特征。方法采集左室射血分数（3D—LVEF）〉50％的尿毒症患者61例和正常对照组31例实时三维全容积图像。由左心室17节段容积-时间曲线测量左心室16节段、12节段和3个短轴水平（基底水平、乳头肌水平和心尖水平）的同步性参数，同步性参数包括达收缩期最小容积时间标准差的标准化值（Tmsv16-SD％、Tmsv12-SD％、Tmsv1-6-SD％、Tmsv7—12-SD％、Tmsv13—16-SD％）和最大时间差的标准化值（Tmsv16-Dif％、Tmsv12-Dif％、Tmsv1-6-Dif％、Tmsv7—12-Dif％、Tmsv13—16-Dif％）。将61例尿毒症患者分为3组：A组19例，为透析时间≤2年的患者；B组22例，为透析时间〉2年～≤4年的患者；C组20例，为透析时间〉4年～≤6年的患者，并将参数进行组间对比。结果与正常对照组比较，尿毒症A、B、c3组左心室16节段、12节段和各短轴水平同步性参数均增大；B组、C组较A组增大；B、C两组组间除Tmsv1-6-Dif％差异有统计学意义，余参数差异无统计学意义。尿毒症组左心室各同步性参数与3D—LVEF间均呈显著负相关。结论RT-3DE可以早期发现尿毒症血液透析患者左心室整体和各个短轴水平内心肌运动的同步性特征，为临床早期无创准确评估左心室局部收缩功能提供了-种定量、定性的方法。Objective To evaluate the left ventricular synchronicity in uremic patients underwent hemodialysis by real - time three - dimensional echocardiography（RT -3DE）. Methods Sixty one uremic patients with 3D - LVEF more than 50% and 31 healthy vol- unteers were enrolled in this study, and clear full volume images were acquired using RT -3DE. The standard deviation （Tmsv -SD% ） and the maximal difference （Tmsv - Dif% ） of Tmsv were calculated for 16 segments, 12 segments and basal level, mid level, apical lever （Tmsv16 - SD% , Tmsv12 -SD% , Tmsv1 -6 - SD% , Tmsv7 - 12 - SD% , Ymsv13 - 16 - SD% , Tmsv16 - Dif % ,Tmsv12 - Dif % , Tmsv1 -6 - Dif % , Tmsv7 - 12 - Dif % , Tmsv13 - 16 - Dif % ）. 61 uremic patients were divided into three groups according to hemodi- alysis time： group A （ ≤2 years） , group B （2 years 〉 time≤ 4 years） , group C （4 years 〉 time ≤ 6 years） , and the parameters were compared between groups. Results Parameter index of 16 segment time to minimal systolic volume in uremic patients were signifi- cantly higher than those in healthy volunteers. The parameters in group A were higher than those of group B and C. There was no differ- ence in any segment between B and C group except Tmsvl - 6 - Dif %. All synehronicity index of uremic patients was correlated signifi- cantly with 3D - LVEF. Conclusion The left ventricular synchronicity in globle and each level can be evaluated in uremic patients un- derwent hemodialysis by RT -3DE and it provides a quantitative and qualitative methods for clinic more accurately.

关 键 词：超声心动描记术 实时三维 心肌 尿毒症 血液透析 左心室功能 

分 类 号：R692[医药卫生—泌尿科学]