维持性血液透析患者左心室舒张功能与并发肺动脉高压的关系  

Relationship between left ventricular diastolic function and pulmonary artery hypertension in the maintenance hemodialysis patients

作　　者：刘文渊[1] 张彦[2] 王军芳[2] 赵寒辉[1] 秦瑜[1] 董磊[2] Liu Wenyuan Zhang Yan Wang Junfang Zhao Hanhui Qin Yu Dong Lei(Department of Ultrasound, Jinan Military General Hospital Blood Purification Center, Jinan 250031, China)

机构地区：[1]济南军区总医院血液净化中心,250031 [2]济南军区总医院超声诊断科,250031

出　　处：《中华消化病与影像杂志（电子版）》2017年第3期101-104,共4页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：山东省自然科学基金面上项目(ZR2013HM026)

摘　　要：目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者的左心室舒张功能与肺动脉高压(pulmonary arterial hypertension,PAH)的关系。方法选取2014年3月至2015年6月在济南军区总医院通过动静脉漏口行MHD治疗并发PAH的患者53例为观察组,无PAH的患者83例为对照组。2组患者均在透析后6h内应用超声心动图获取左心室射血分数(left ventricular ejection fraction,LVEF),二尖瓣E/A,启动左心房容积追踪技术(left atrial volume tracking technique,LAVT)获取最大左心房容积(left atrial volume,LAVm),应用斑点追踪技术(speckle tracking technique,STI)获取左室壁收缩期峰值应变率、舒张早期峰值应变率和舒张晚期峰值应变率的平均值(mSRs、mSRe、mSRa)及计算mSRe/mSRc,参数在两组间比较采用t检验,以P<0.05为差异有统计学意义。结果反映左心室收缩功能的LVEF、mSRs在两组间差异无统计学意义(P>0.05)。LAVmax在两组间差异有统计学意义(P<0.05)。反映左心室舒张功能的E/A、mSRe、mSRe/m SRa在两组间差异有统计学意义(P<0.05)。结论 MHD患者舒张功能降低是并发PAH的因素之一。Objective To investigate the relationship of the left ventrieular diastolic function and pulmonary artery hypertension （ PAH ） in the maintenance hemodialysis （ MHD ） patients. Methods From March 2014 to June 2015,53 eases of MHD patients with PAH and 83 eases of MHD patients without PAH were selected in Jinan Military General Hospital. Six hours after hemodialysis,left ventricular ejection fraction （LVEF）, mitral E peak and A peak ratio （ E/A ） of all patients were obtained by conventional eehoeardiography. The maximum left atrial volume （LAVm）was obtained by the left atrial volume tracking technique（LAVT）. The average values of left ventrieular wall systolie peak strain rate, early diastolic peak strain rate,late diastolic peak strain rate （mSRs, mSRe, mSRa）were obtained by speckle tracking technique （STI）, and mSRe/mSRa was calculated. All the data were compared between the two groups using t test, and P value of 〈 0. 05 was considered statistically significant. Results There were no statistically significant differences in reflecting the left ventricular systolic funetion indexes LVEF and mSRs between the two groups （ P 〉 0. 05 ）. The difference of LAVmax between the two groups was statistically significant （ P 〈 0. 05 ）. The differences of reflecting the left ventrieular diastolic function indexes E/A, mSRe, mSRe/mSRa between the two groups were statistically significant （ P 〈 0. 05 ）. Conclusion The impaired left ventricular diastolie function is associated with PAH in patients with MHD.

关 键 词：血液透析 高血压 肺性 左心室舒张功能 斑点追踪技术 

分 类 号：R459.5[医药卫生—治疗学]