分层应变技术评价维持性血液透析患者左心室收缩功能及同步性的价值  

Evaluation of left ventricular systolic function and synchronicity in patients with maintenance hemodialysis by layer-specific strain

作　　者：黑晶晶 魏常华 朱好辉 李杨 丁晓 谷春红 袁建军 Hei Jingjing;Wei Changhua;Zhu Haohui;Li Yang;Ding Xiao;Gu Chunhong;Yuan Jianjun.(Department of Ultrasound, the People＇s Hospital of Zhengzhou University, Zhengzhou 450003, Chin)

机构地区：[1]郑州大学人民医院超声科,450003

出　　处：《中华超声影像学杂志》2018年第5期380-384,共5页Chinese Journal of Ultrasonography

基　　金：国家卫生计生委2013-2015年度国家临床重点专科建设项目（2013226）;河南省科技攻关计划项目（201602212）

摘　　要：目的探讨分层应变技术评价维持性血液透析（MHD）患者左室收缩功能及同步性的价值。方法收集43例MHD患者（MHD组），48例年龄、性别匹配的健康志愿者为对照组，采集左室心尖两腔、三腔、四腔长轴及左室基底段、中段、心尖段三个短轴水平的二维灰阶动态图像。应用EchoPAC工作站，分析图像得到左室心肌的纵向应变（LS）、圆周应变（CS）参数及各节段纵向应变达峰时间的标准差即峰值应变离散度（PSD）。比较两组间各参数的差异性，并研究PSD与其他参数间的相关性。结果整体分层应变参数：MHD组整体内、中、外三层及全层LS、CS均低于对照组，差异有统计学意义（P〈0．01）。节段分层应变参数：MHD组基底段、中段、心尖段三层及全层心肌LS均低于对照组（P〈0．001）。MHD组中段、心尖段三层及全层心肌CS均低于对照组（P〈0．05）。基底段三层及全层CS差异均无统计学意义（P〉0．05）。同步化参数：MHD组PSD高于对照组（t=6．094，P〈0．001）。MHD组PSD与整体全层纵向应变（GLS）呈正相关（rs=0．478，P=0．039）。结论分层应变技术能够无创定量评价MHD患者左室收缩功能及同步性下降程度。Objective To explore the systolic function and synchronicity of left ventricle （LV） in patients with maintenance hemodialysis（MHD） by layer-specific strain. Methods Forty-three patients with MHD and 48 healthy controls were studied. Three consecutive cardiac cycles two-dimensional dynamic images including standard LV apical two-chamber, long-axis and four-chamber views and LV short-axis views at the levels of basal, middle and apical were acquired. A quantitative software called EchoPAC was used to analyze longitudinal strain（LS） and circumferential strain（CS） of these six dynamic images and peak strain dispersion （PSD） was automatic computed by the software. The difference of these parameters between the two groups and the correlation between PSD and other parameters were studied. Results Parameters of global layer-specific strain： compared with the control group, global LS and CS of subendocardial, midmyoeardial, epicardial and full-thickness myocardium layers were decreased in the MHD group （ P 〈0.01）. Parameters of segmental layer-specific strain：LS of 3 layers and full-thickness in basal, middle, apical segments were lower in MHD group than those in control group （ P 〈0. 001）. CS of 3 layers and full-thickness in middle, apical segments were lower in MHD group than those in control group （ P 〈 0. 05）. There was no significant difference in CS of 3 layers and full-thickness in basal segment between two groups（ P 〉0.05）. Parameters of synchronicity：PSD of MHD group was larger than that of control group （ t = 6. 094, P 〈0.001）. PSD was positively correlated with longitudinal strain of full-thickness （GLS） in MHD group （rs = （5. 478, P = 0.（539）. Conclusions Layer-specific strain can noninvasively and accurately quantitate left ventricular systolic function and synchronicity in patients with MHD.

关 键 词：超声心动描记术 肾透析 心室功能 左 分层应变 

分 类 号：R445.1[医药卫生—影像医学与核医学] R459.5[医药卫生—诊断学]