三维斑点追踪成像技术评价早期慢性肾病患者左室局部收缩功能  

Evaluation of left ventricular regional systolic function in patients with early chronic kidney disease by three-dimensional speckle tracking echocardiography

作　　者：范一宁 任卫东[1] 姜克新[1] 栾朝霞[1] 张颖[1] FAN Yi-ning;REN Wei-dong;JIANG Ke-xin;LU AN Zhao-xia;ZHANG Ying(Department of Ulirasonography,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院超声科

出　　处：《中国临床医学影像杂志》2019年第6期409-412,440,共5页Journal of China Clinic Medical Imaging

基　　金：国家自然科学基金(81571686)

摘　　要：目的 :应用三维斑点追踪成像技术(Three-dimensional speckle tracking echocardiography,3D-STE)对早期慢性肾病(Chronic kidney disease,CKD)患者评价左室局部收缩功能。方法:选取2017年6月-2018年9月于我院就诊病情稳定的CKD患者40例及健康志愿者26例(对照组),按肾小球滤过率将患者分为CKD2期组、CKD3期组及对照组,其中CKD2期患者20例,CKD3期患者20例。进行常规二维超声心动图和三维斑点追踪成像,比较各组间参数的差异。结果:①CKD2期组与对照组,侧壁心尖段(AL)、间隔心尖段(AS)、下壁中间段(MI)、前间隔中间段(MAS)、前壁基底段(BA)、前间隔基底段(BAS)、后壁基底段(BP),应变值于收缩期纵向应变(SLS)、收缩期面积应变(SAS)、收缩期圆周应变(SCS)、收缩期径向应变(SRS)显著减低(P<0.05);②CKD3期组与CKD2期组,心尖部(Apex)、间隔心尖段(AS)、前壁中间段(MA)应变值在SLS、SAS、SCS、SRS显著减低(P<0.05),在SLS中有较多的节段差异显著。结论:应用3D-STE能评价早期CKD患者左室局部收缩功能,其中SLS是较敏感指标。Objective: Left ventricular regional systolic function was evaluated in patients with early stage chronic kidney disease (CKD) using three-dimensional speckle tracking echocardiography (3D-STE). Methods: From June 2017 to September 2018, 40 patients with early CKD and 26 healthy volunteers (control group) were enrolled in our hospital. The patients were divided into CKD stage 2, CKD stage 3 and control group according to glomerular filtration rate, including 20 patients with CKD stage 2 and 20 patients with CKD stage 3. Conventional two-dimensional echocardiography and 3D-STE were performed, and the differences in parameters between the groups were compared. Results:① In the CKD stage 2 group and control group, the strain values of apicallateral (AL), apicalseptum (AS), midinferior (MI), midanteroseptal (MAS), basalanterior (BA), basalanteroseptal (BAS), and basal posterior (BP) strain values were significantly reduced in systolic longitudinal strain (SLS), systolic area strain (SAS), systolic circumferential strain (SCS), systolic radial strain(SRS)(P<0.05);② In the CKD stage 3 group and the CKD stage 2 group, the apex (Apex), AS, and midanterior(MA) strain values were significantly reduced in SLS, SAS, SCS, and SRS(P<0.05). There are more segmental differences in SLS. Conclusion: 3D-STE can be used to evaluate the left ventricular regional systolic function in patients with early CKD, and SLS is a sensitive index.

关 键 词：心室功能 左 肾疾病 超声心动描记术 多普勒 彩色 

分 类 号：R331.31[医药卫生—人体生理学] R692[医药卫生—基础医学]