慢性肾功能不全患者左室舒张功能的评价  

A Study of Left Ventricle Diastolic Function in Chronic Renal Insufficiency

作　　者：刘秋颖 杨克 张添添 Liu Qiuying;Yang Ke;Zhang Tiantian(Department of Ultrasound,the Sixth Medical Center of PLA General Hospital,Beijing 100048,China)

机构地区：[1]解放军总医院第六医学中心超声科

出　　处：《中国超声医学杂志》2019年第10期918-921,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的超声心动图评价肾功能不全患者左室舒张功能。方法将89例肾功能不全患者依据肾小球滤过率分为轻度肾功能受损(A组)、中度(B组)和重度肾功能受损(C组)三组。全部病例记录血压和B型尿钠酸(BNP)后超声测量左室舒张末前后径(LVd)、左室心肌质量指数(LVMI)、左房容积指数(LAVI)、射血分数(EF)、三尖瓣反流流速(TR),计算二尖瓣口舒张早期流速与舒张晚期流速比值(E/A)、组织多普勒测量二尖瓣环舒张早期运动速度(e′),并计算E/e′。依据2016年ASE/EACVI《关于超声心动图评估左室舒张功能的建议》进行舒张功能分级。结果(1)LAVI、TR和E/e′在C组显著大于B组,B组大于A组,呈递增趋势,e′相反,呈递减趋势;C组的LVMI大于A组。(2)A组中舒张功能Ⅰ级14例,Ⅱ级1例;B组中Ⅰ级33例,Ⅱ级15例,Ⅲ级4例;C组中Ⅰ级3例,Ⅱ级16例,Ⅲ级3例。(3)Pearson相关分析显示LVd、LVMI、LAVI和E/e′与BNP有相关性,相关系数分别为0.56、0.45、0.61、0.75。结论超声心动图能够评价左室舒张功能并分级,对慢性肾功能不全患者早期诊断舒张性心力衰竭具有重要价值。Objective To assess left ventricle diastolic function in chronic renal insufficiency(CRI)by echocardiography.Methods 89 CRI patients were divided into 3 groups on base of glomerular filtration rate.Group A was light insufficiency;group B was morderate insufficiency and group C was severe insufficiency.We recorded blood pressure and brain natriuretic peptide(BNP)of every patient.All patients were underwent echocardiography and were measured left ventricle diameter(LVd),left ventricle mass index(LVMI),left atrial volume index(LAVI),ejection fraction(EF),the ratio of mitral early diastolic velocity and mitral lately diastolic velocity(E/A),the velocity of tricuspid valve regurgitation(TR).The ratio of early mitral inflow velocity to early diastolic mitral annular velocity(E/e′)was detected by Tissue Doppler imaging.We classificated left diastolic function according to a recommendation of ASE/EACVI in 2016.Results(1)LAVI,TR and E/e′in group C were higher than those in group B,those in group B were higher than those in group A.(2)There were 14 patients of diastolic insufficiency Grade 1 and 1 patient of Grade 2 in group A.There were 15 patients of diastolic insufficiency Grade 2 and 4 patients of Grade 3 in group B.There were 16 patients of diastolic insufficiency Grade 2 and 3 patients of Grade 3 in group C.(3)Pearson relative analysis showed LVd、LVMI、LAVI and E/e′were associated with BNP(r=0.56,0.45,0.61,0.75).Conclusions Echocardiography should be used to evaluate and classificate left ventricle diastolic function.

关 键 词：肾功能不全 左室 舒张 

分 类 号：R445.1[医药卫生—影像医学与核医学] R692[医药卫生—诊断学]