二维斑点追踪成像技术评价腹膜透析对尿毒症患者左心室功能影响的临床研究  

Clinical study of left ventricular systolic function of uremic treated with peritoneal dialysis measured by two-dimensional speckle tracking imaging

作　　者：贾春梅[1] 常荷[1] 薛影[1] 梁永超[1] 徐宇雪[1] 王健[1] Jia Chunmei;Chang He;Xue Ying;Liang Yongchao;Xu Yuxue;Wang Jian(Department of Ultrasonography, the First Hospital of Shanxi Medical University, Taiyuan 030001, China)

机构地区：[1]山西医科大学第一医院超声科,太原030001

出　　处：《中华医学超声杂志（电子版）》2017年第10期771-778,共8页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨二维斑点追踪成像技术(2D-STI)评价腹膜透析对尿毒症患者左心室功能影响的价值。方法选取2014年12月至2015年12月经山西医科大学第一医院诊断明确且尚未透析的尿毒症患者30例,作为尿毒症患者组,常规超声示左心室射血分数(LVEF)>50%,与年龄、性别、体重相匹配的健康对照组30例比较。2组均测量基础资料与心脏常规超声参数,采集图像并采用QLab软件分析,得出左心室16节段时间-应变曲线,测出各节段纵向、径向、圆周方向收缩期峰值应变。对2组基础资料、常规超声参数及左心室各节段2D-STI参数行两独立样本t检验。腹膜透析6个月后再次检查,采用配对t检验比较尿毒症患者腹膜透析前后左心室各节段心肌收缩情况。结果 (1)尿毒症患者组(未透析)与健康对照组比较:尿毒症患者组收缩压、舒张压及脉压升高,差异均有统计学意义(t=-4.445、-4.531、-2.203,P均<0.05);尿毒症患者左心房前后径、左心室舒张末及收缩末内径、左心室舒张末及收缩末容积及左心室质量指数增大,室间隔厚度、左心室后壁厚度及相对室壁厚度增厚,差异均有统计学意义(t=-6.461、-5.168、-4.660、-3.578、-2.872、-6.819、-6.251、-7.108、-2.659,P均<0.05),LVEF差异无统计学意义(P>0.05);尿毒症患者组左心室16节段纵向、径向及圆周方向收缩期峰值应变均减小,差异均有统计学意义(纵向t=-7.063、-5.391、-3.351、-5.323、-5.586、-7.842、-5.265、-5.587、-5.037、-3.051、-4.584、-3.936、-4.168、-9.783、-9.175、-3.805;径向t=3.659、3.581、5.368、2.649、2.928、4.344、2.754、5.031、5.025、2.277、2.691、2.731、3.187、4.179、5.292、4.429;圆周方向t=-5.158、-3.959、-2.164、-3.592、-2.324、-5.672、-4.946、-7.184、-7.748、-5.014、-2.439、-6.299、-8.072、-8.410、-7.884、-8.854,P均<0.05)。(2)尿毒症患者透析前后比较:尿毒症患者透析治疗后收缩压降低,差异有统计学�To evaluate the left ventricular systolic function of uremic patients after peritoneal dialysis measured by two-dimensional speckle tracking imaging. Methods Thirty uremicpatients with their left ventricular ejection fraction (LVEF) > 50% who had not been underwent dialysiswere enrolled in this study. Thirty healthy volunteers were involved as controls. For both groups, the basicdata and routine cardiac ultrasound parameters were measured, and the images were collected to be analyzedby QLab software. The left ventricular 16-segment time-strain curves were obtained, and the peak strain ofthe systolic phase of each segment was measured. The data of 2 groups were analyzed by two independentsamples t-test. After 6 months of peritoneal dialysis, the uremic patients were checked again. By usingpaired t-test, we analyzed the difference in left ventricular systolic dysfunction of uremic patients before andafter peritoneal dialysis.

关 键 词：超声心动描记术 心室功能 左 尿毒症 腹膜透析 

分 类 号：R540.45[医药卫生—心血管疾病] R692.5[医药卫生—内科学]