三维面积应变评价早期慢性肾病患者左心室心肌收缩功能的变化  

Three-dimensional Area Strain in Evaluating the Changes of Left Ventricular Myocardial Contractional Function in Patients with Early Chronic Kidney Disease

作　　者：刘开薇 任卫东[1] 孙璐[1] 宋光[1] 刘慧[1] 乔伟[1] 

机构地区：[1]中国医科大学附属盛京医院超声科,沈阳110004

出　　处：《中国医科大学学报》2016年第2期116-119,共4页Journal of China Medical University

基　　金：辽宁省科学技术计划(2013225049)

摘　　要：目的应用三维面积应变(GAS)评价早期慢性肾病(CKD)患者左心室心肌收缩功能。方法选取26例CKD 2期患者、20例CKD 3期患者及30例健康志愿者(对照组)。行常规二维超声心动图和三维斑点追踪成像(3D-STE),测量并比较常规超声心动图指标[室间隔舒张末期厚度(IVSTd)、左心室舒张末期内径(LVEDd)、舒张末期左心室后壁厚度(LVPWTd)、舒张末期左心室容积(EDV)、收缩末期左心室容积(ESV)]和3D-STE指标[左心室三维射血分数(3D-LVEF)、三维左心室心肌质量指数(3D-LVMi)及左心室整体面积应变(GAS)]差异。结果与对照组相比,CKD 2期患者的IVSTd增大,LVEDd、GAS减小;CKD 3期的IVSTd、LVESV、3D-LVMi显著增大,LVEDd、3D-LVEF、GAS显著减小。与CKD 2期相比,CKD 3期的IVSTd、3D-LVMi增大,LVEDd、GAS减小,以上差异均有统计学意义(均P<0.05)。结论 CKD早期患者左心室心肌收缩功能已经减低,可通过GAS来评价。Objective To assess the early changes of left ventricular myocardial contractional function in patients with early chronic kidney disease （ CKD ） using three-dimensional global area strain （GAS）. Methods A total of 26 cases of CKD2,20 cases of CKD3 mad 30 eases of healthy sub- jects as control group were recruited in this study. Parameters of two-dimensional eehocardiography including left ventricular at end-diastole diameter （LVEDd）, intervenlrieularseptal thickness at end-diastole （IVSTd）, left ventricular posterior wall thickness at end-diastole （LVPWTd）, end- dia- stolic volume （EDV） , end-systolic volume （ESV） and parameters of 3D- STE including three-dimensional left ventrieular ejection fraction （ 3D- LVEF）, three-dimensional LV mass index （ 3D -LVMi ）, and global area strain （ GAS ） were calculated and compared. Results Compared with the control group, IVSTd was increased in CKD2 group, while LVEDd and GAS were decreased; in CKD3 group, IVSTd, LVESV, and 3D-LVMi were increased, LVEDd, 3D-LVEF, and GAS were decreased. Compared with the CKD2 group, in CKD3 group, IVSTd and 3D-LVMi were increased, LVEDd and GAS were decreased （P 〈 0.05 ）. Conclusion On the early stages of CKD, the left ventrieular myocardial contractive function was reduced, which can be detected by 3D-STE with GAS.

关 键 词：超声心动描记术 三维 慢性肾病 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R692.9[医药卫生—内科学]