三维斑点追踪显像技术评价慢性肾脏病患者左室整体及局部收缩功能的研究  

Assessment of global and regional left ventricular systolic function in patients with chronic kidney diseases by three-dimensional speckle tracking imaging

作　　者：柯茜茜 杨静洲 欧阳达 KE Qianqian;YANG Jingzhou;OUYANG Da(Department of Ultrasound,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院超声影像科,武汉市430071

出　　处：《临床超声医学杂志》2018年第9期590-593,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的应用三维斑点追踪显像(3D-STI)技术评价慢性肾脏病(CKD)患者左室整体及局部收缩功能,探讨左室整体、局部应变与左室射血分数(LVEF)间的关系。方法选取CKD患者48例,其中左室射血分数(LVEF)≥55%者21例(A组),LVEF<55%者27例(B组),以及健康成人20例(健康对照组)。应用3D-STI获得左室整体纵向应变(GSL)、整体面积应变(GSA)、整体径向应变(GSR),以及各节段的纵向应变(r SL)、径向应变(r SR)、面积应变(r SA)。采用Pearson相关分析法分析CKD患者GSL、GSA、GSR与LVEF之间的相关性。结果 (1)整体应变:各组GSL、GSA、GSR比较,差异均有统计学意义(均P<0.01);两两比较中,A组GSL较健康对照组减低,B组GSL、GSA、GSR较健康对照组减低,差异均有统计学意义(均P<0.01);(2)局部应变:各组r SL、r SA、r SR比较差异均有统计学意义(均P<0.05);与健康对照组比较,A组基底段r SL明显减低,差异有统计学意义(P<0.01),中间段、心尖段变化不明显;与健康对照组和A组比较,B组基底段、中间段、心尖段r SR、r SA均明显减低,差异均有统计学意义(均P<0.05)。CKD患者GSL、GSA、GSR均与LVEF均具有良好的相关性(r=-0.712、0.760、-0.810,均P<0.01)。结论 3D-STI可有效评估CKD患者左室收缩功能,且整体及局部纵向应变均能较敏感地识别CKD患者左室收缩功能受损情况。Objective To evaluate global and regional left ventricular（LV） strain in patients with chronic kidney diseases（CKD）by three-dimensional speckle tracking imaging（3 D-STI）,and to discuss the relationship between global strain,regional strain and ejection fraction of LV（LVEF）.Methods Forty-eight CKD patients were enrolled in this study,including 21 patients with LVEF≥55% in group A,27 patients with LVEF55% in group B,and 20 healthy controls.Global peak longitudinal strain（GSL）,global peak area strain（GSA）,global peak radial strain（GSR）,regional peak longitudinal strain（r SL）,regional peak area strain（r SA）,regional peak radial strain（r SR）were measured by 3 D-STI.Then the relationship between GSL,GSA,GSR and LVEF were discussed by the Pearson correlation analysis.Results（1） Global peak strain：the GSL,GSA,GSR were statistically different in the control group,in group A and group B（all P〈0.05）.There were significant differences between groups as following：GSL was lower in group A（P〈0.01）,GSL,GSA,GSR were lower in group B compared with control group（all P〈0.01）.（2）Regional peak strain：the r SL,r SA,r SR were statistically different in the control group,group A and group B（all P〈0.05）.Compared with control group,r SL of basal segments was lower in group A,while there were no differences in middle and apical segments. Compared with control group and group A,r SR,r SA in group B were lower from the basal to the apical segments（all P〈0.05）.Pearson correlation analysis revealed GSL,GSA,GSR were strongly associated with LVEF（r=-0.712,0.760,-0.810,all P〈0.01）.Conclusion 3 D-STI is an effective way to evaluate the systolic function of LV in CKD patients.The global and regional peak longitudinal strain can recognize systolic dysfunction more sensitively.

关 键 词：斑点追踪显像 三维 慢性肾脏病 应变 心室 左 

分 类 号：R692[医药卫生—泌尿科学] R540.45[医药卫生—外科学]