血液透析尿毒症患者右心室壁心肌运动与左心室功能的关系研究  

Relationship between myocardial motions of right ventricular walls and cardiac functions of left ventricle in uremic patients with maintenance hemodialysis

作　　者：高继康[1] 梅旭峰[2] 沈军[2] 庄国华[2] 张云龙 GAO Jikang,;MEI Xufeng;HEN Jun

机构地区：[1]杭州市余杭区第一人民医院(浙江大学医学院附属第二医院余杭分院)超声科,311100 [2]杭州市余杭区第一人民医院(浙江大学医学院附属第二医院余杭分院)血透室,311100

出　　处：《浙江医学》2018年第5期457-461,共5页Zhejiang Medical Journal

基　　金：杭州市卫生科技计划项目(2014B30)

摘　　要：目的探讨维持性血液透析尿毒症患者右心室壁局部心肌运动参数与左心室功能指标的关系。方法选取维持性血液透析的尿毒症患者135例(血液透析组)和体检的正常成人41例(正常对照组)为研究对象,均进行超声心动图检查,测定右心室前、下、侧壁的基底段、中段、心尖段心肌的收缩期组织速度和位移,以及舒张早、晚期组织速度。比较两组受检者右心室壁局部心肌运动参数与左心室功能指标,并分析血液透析组患者右心室壁心肌运动参数与左心室功能指标的相关性。结果血液透析组患者大部分右心室壁心肌运动参数与左心室功能指标均低于正常对照组(均P<0.05)。血液透析组患者侧壁基底段收缩期组织速度与左心室心输出量相关性较强(r=0.31,P<0.05),直线回归方程为Y=0.28X+4.76;下壁中段收缩期组织位移与二尖瓣环舒张晚期速度相关性较强(r=0.25,P<0.05),直线回归方程为Y=0.37X+10.02。结论维持性血液透析尿毒症患者左心室整体收缩与舒张功能对右心室壁局部心肌运动有一定影响,同时右心室壁局部心肌运动可反映左心室整体心功能。Objective To explore the relationship between the parameters of myocardial motions of right ventricular walls and the indices of cardiac functions of left ventricle in uremic patients with maintenance hemodialysis.Methods One hundred and thirty five uremic patients with maintenance hemodialysis(hemodialysis group)and41healthy subjects(control group)were enrolled in the study.The systolic tissue velocity,systolic tissue displacement,early distolic velocity and atrial systolic velocity of every segment of right ventricle were measured by echocardiography,and the parameters of myocardial motions of right ventricular walls and the indices of cardiac functions of left ventricle were compared between two groups.The linear regression correlation between the parameters of myocardial motions of right ventricular walls and the indices of cardiac functions of left ventricle in patients of hemodialysis group was analyzed.Results The parameters of myocardial motions of right ventricular wall and the indices of cardiac functions of left ventricle in the patients of hemodialysis group were lower than those in control group(all P<0.05).The systolic velocity of basal segment of lateral wall(LVbs)was correlated with left ventricular cardiac output(LVCO)in hemodialysis group(r=0.31,P<0.05)with a linear regression equation of Y=0.28X+4.76.The systolic displacement of mid segment of inferior wall(IDms)was correlated with atrial velocity of mitral valve annulus(MVa)(r=0.25,P<0.05)with a linear regression equation of Y=0.37X+10.02.Conclusion In the uremic patients with hemodialysis,the integral systolic and diastolic function of left ventricle can affect the myocardial motions of right ventricular wall;on the contrary,the right ventricular regional myocardial motions can reflect the left ventricular integral function.

关 键 词：超声心动图 尿毒症 组织多普勒显像 心功能 右心室 

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