组织运动二尖瓣环位移自动追踪技术在评价尿毒症患者左室收缩功能早期受损中的价值  

Value of automated motion tracking of mitral annular displacement in assessing early change of left ventricular systolic function in patients with uremia

作　　者：苏军芳[1] 王银[1] 芮海荣[2] 孙艳丹[1] 王章华[2] 张军[3] 

机构地区：[1]解放军第四五一医院特诊科,西安市710054 [2]解放军第四五一医院血液透析中心,西安市710054 [3]第四军医大学西京医院超声科

出　　处：《临床超声医学杂志》2016年第2期77-80,共4页Journal of Clinical Ultrasound in Medicine

基　　金：陕西省科学技术研究发展计划项目(2013K12-20-07)

摘　　要：目的应用组织运动二尖瓣环位移自动追踪技术测定二尖瓣环向心尖移动的距离,分析其在评价尿毒症患者左室收缩功能的应用价值。方法 45例尿毒症患者分为左室肥厚(LVH组)25例和左室未见肥厚(NLVH组)20例,另选取30例正常成人为对照组。应用组织二尖瓣环位移自动追踪技术测量各组心尖四腔切面、心尖左室长轴切面及心尖两腔切面的二尖瓣环位移,并用Simpsons法测定左室射血分数。结果 NLVH组二尖瓣环位移除左室前壁、后壁外其余室壁均较对照组明显减低(均P<0.05),LVH组左室所有室壁的二尖瓣环位移均较对照组明显减低(均P<0.05)。LVH组和NLVH组其收缩期二尖瓣环连线中点的最大位移、收缩期二尖瓣环连线中点的最大位移占左室长轴的百分比及其均值较对照组明显减低(P<0.05)。尿毒症患者在左室射血分数正常的情况下,二尖瓣环位移的相关指标较对照组减低(P<0.05)。结论组织运动二尖瓣环位移自动追踪技术提供了一种简便、精准地评价急性尿毒症患者左室整体收缩功能的方法,能早期评估左室整体收缩功能。Objective To evaluate the application value of tissue motion mitral annular displacement （TMAD） in assessment of the left ventricular systolic function in patients with uremia through determination of the mitral annular to the apex displacement. Methods Forty-five patients with uremia including 25 patients with left ventricular hypertrophy （LVH group ）, 20 patients without left ventricular hypertrophy （NLVH group ） and 30 normal control subjects were enrolled in the study. The mitral annular displacement（ MAD ）in three groups were evaluated in the apical four-chamber, two-chamber and long axis views by TMAD. The left ventricular ejection fraction（LVEF） was determined using Simpson＇ s method. Results MAD of the rest wall except the left ventricular anterior wall and posterior wall in NLVH group, and MAD of all left ventricular wall in LVH group were significantly reduced than those in control group（ all P〈0.05 ）. The maximum displacement of the midpoint connecting mitral annular（TMADmidpt）, the ratio of the maximum displacement of the midpoint accounted for length diameter of left ventricle and it＇s mean value in NLVH and LVH groups were significantly reduced than those in control group （P〈0.05）. In uremia patients with normal LVEF, indexes of MAD significantly decreased than those in control group（P〈0.05 ）. Conclusion TMAD is a simple and accurate method for evaluating global left ventricular systolic function in patients with uremia, it can be used for more early assessment of global left ventricular systolic function.

关 键 词：超声心动描记术 尿毒症 心功能 二尖瓣环位移 

分 类 号：R541.9[医药卫生—心血管疾病] R540.45[医药卫生—内科学]