三维超声心动图评价慢性肾脏疾病患者左房容积和功能的初步研究  

Assessment of Left Atrial Volume and Function in Patients with Chronic Kidney Disease by Three-dimensional Echocardiography

作　　者：孔双双 李玲[1] 谢明星[1] 方凌云 章子铭 Kong Shuangshuang;Li Ling;Xie Mingxing;Fang Lingyun;Zhang Ziming(Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, Chin)

机构地区：[1]华中科技大学同济医学院附属协和医院超声影像科,武汉市430022

出　　处：《中国超声医学杂志》2018年第7期628-631,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用三维超声心动图(3DE)评价慢性肾脏疾病(CKD)患者左房容积和功能。方法 CKD 2～5期非透析患者102例和正常者28例,根据GFR水平将CKD患者分为CKD 2～5组。采集全容积3DE图像,软件脱机分析,获取左心房容积曲线及左房各3DE容积参数,比较各组间各参数的差异。结果 (1)左房储备功能3DE参数比较:CKD各组左房最大容积指数(LAVImax)、左房收缩前容积指数(LAVIp)均较正常组增高(P<0.05),以CKD4、CKD5组明显;CKD4、CKD5组左房最小容积指数(LAVImin)较正常组、CKD2组和CKD3组增高(P<0.05);CKD4、CKD5组左房总排空指数(LAVItotal)、左房总排空分数(LATEF)较正常组增高(P<0.05)。(2)左房管道功能3DE参数比较:CKD各组左房被动排空分数(LAPEF)较正常组减低(P<0.05),以CKD5组明显。(3)左房助力泵功能3DE参数比较:CKD各组LAVIact均较正常组减低(P<0.05),以CKD5组明显。结论 CKD2～5期患者左房容积指数、储备功能和助力泵功能增加,左房管道功能减低,3DE可早期评估CKD患者左房结构与功能改变。Objective To evaluate the left atrial volume and function in patients with chronic kidney disease by three-dimensional echocardiography.Methods 102 CKD stage 2-5 patients without dialysis and 28 age and sex matched normal subjects were selected.Patients with CKD were divided into CKD2 group to CKD5 group according to the level of GFR.Full volume three-dimensional echocardiographic images were collected and analyzed by offline software.Left atrial volume curve and three-dimensional echocardiographic left atrial volume parameters were acquired.Results（1）Three-dimensional echocardiographic volume parameters for left atrial reservoir function：Compared with the normal group,LAVImax and LAVIp were increased in CKD groups（P〈0.05）,the increase in CKD4,CKD5 groups were significant.LAVImin in CKD4 and CKD5 groups were higher than that of normal、CKD2 and CKD3 groups（P〈0.05）.LAVTtotal,LATEF in CKD4 and CKD5 groups were higher than that of normal group（P〈0.05）.（2）Three-dimensional echocardiographic volume parameters for left atrial conduit function：Compared with the normal group,LAPEF was decreased in all CKD groups（P〈0.05）,the decrease in CKD5 group was significant.（3）Three-dimensional echocardiographic volume parameters for left atrial booster pump function：Compared with the normal group,LAVIact was decreased in all CKD groups（P〈0.05）,the decrease in CKD5 group was significant.Conclusions The left atrial volume index,reservoir function,booster pump function were increased and conduit function was decreased in CKD2-5 stages patients.Three-dimensional echocardiography could assess the changes of left atrial structure and function in patients with CKD early.

关 键 词：慢性肾脏疾病 左心房 三维超声心动图 

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