实时三维斑点追踪成像技术评价不同透析方式终末期肾病患者的左心房容积及功能  

Assessment of left atrial volume and function by real-time three-dimensional speckle tracking imaging in end-stage renal disease patients with different dialysis methods

作　　者：陈晓菲 姜志荣[1] 杨攀玉 孙品[1] 何香芹[1] 王小凡[1] 吕启凤[1] 宋晓霞[1] 田雨[1] Chen Xiaofei;Jiang Zhirong;Yang Panyu;Sun Pin;He Xiangqin;Wang Xiaofan;Lyu Qifeng;Song Xiaoxia;Tian Yu(Department of Cardiac Ultrasound,the Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院心脏超声科,266000

出　　处：《中华超声影像学杂志》2020年第4期308-313,共6页Chinese Journal of Ultrasonography

摘　　要：目的:探讨实时三维斑点追踪成像(RT3D-STI)技术评价不同透析方式终末期肾病(ESRD)患者左心房容积及功能的价值。方法:选取2019年2-8月就诊于青岛大学附属医院的ESRD患者83例,分为未透析组(25例)、血液透析组(HD组,31例)及腹膜透析组(PD组,27例),另选30例健康志愿者为对照组,应用RT3D-STI技术获取左心房容积指数[左心房最大容积指数(LAVImax)、左心房最小容积指数(LAVImin)、左心房主动收缩前容积指数(LAVIpre)]、左心房功能参数[左心房射血分数(LAEF)、左心房被动射血分数(LApEF)、左心房主动射血分数(LAaEF)]及左心房心肌应变参数[整体纵向应变(GLS)、径向应变(GRS)、圆周应变(GCS)],比较各组间上述参数的差异,分析心肌应变参数与透析时间的相关性。结果:①未透析组、PD组及HD组LAVImax、LAVImin、LAVIpre较对照组增大,LAEF、LApEF、GLS、GRS、GCS较对照组减小(均P<0.05);PD组LAVImin及HD组LAVImax、LAVImin、LAVIpre较未透析组增大,PD组LAEF、LApEF、GLS、GCS及HD组LAEF、LApEF、GLS、GRS、GCS较未透析组减小(均P<0.05);HD组LAVImax、LAVImin、LAVIpre较PD组增大,LAEF、LApEF、GLS、GRS、GCS较PD组减小(均P<0.05)。②PD组GLS、GCS与透析时间呈负相关(r=-0.670,-0.596;均P<0.05),HD组GLS、GCS、GRS与透析时间呈负相关(r=-0.624,-0.631,-0.551;均P<0.05)。结论:RT3D-STI技术可对不同透析方式患者的左心房容积及功能作出有效评价,对评估患者预后、指导临床及时干预治疗有重要意义。Objective To discuss the value of real-time three-dimensional speckle tracking imaging(RT3D-STI)in the evaluation of the left atrial(LA)volume and function in end-stage renal disease(ESRD)patients with different dialysis methods.Methods Eighty-three ESRD patients who were treated in the Affiliated Hospital of Qingdao University from February to August 2019 were enrolled and divided into non-dialysis group(n=25),hemodialysis group(HD group,n=31)and peritoneal dialysis group(PD group,n=27).And 30 healthy volunteers were enrolled as control group.Subsequently,the LA volume indexs including LA maximal volume index(LAVImax),LA minimal volume index(LAVImin)and LA presystolic volume index(LAVIpre),the LA function parameters including LA ejection fraction(LAEF),LA passive ejection fraction(LApEF)and LA active ejection fraction(LAaEF)and the LA global strain parameters including global longitudinal strain(GLS),global radial strain(GRS)and global circumferential strain(GCS)were obtained by RT3D-STI.The differences of the parameters among these groups were compared and the correlations between the myocardial strain parameters and dialysis time were analyzed.Results①The LAVImax,LAVImin and LAVIpre of the non-dialysis group,PD group and HD group were higher than those in the control group,while the LAEF,LApEF,GLS,GRS and GCS were lower than those in the control group(all P<0.05);the LAVImin of the PD group as well as the LAVImin,LAVIpre and LAVImax of HD group were higher than those of non-dialysis group,while the LAEF,LApEF,GLS,GCS of the PD group and the LAEF,LApEF,GLS,GRS,GCS of HD group were lower than those of non-dialysis group(all P<0.05).The LAVImax,LAVImin,LAVIpre of HD group were higher than those of PD group,while the LAEF,LApEF,GLS,GRS and GCS of HD group were lower than those of PD group(all P<0.05).②The GLS and GCS in PD group were negatively correlated with the dialysis time(r=-0.670,-0.596,all P<0.05),and the GLS,GCS and GRS in HD group were negatively correlated with the dialysis time(r=-0.624,-0.631,-0.5

关 键 词：三维斑点追踪成像 终末期肾病 心房功能 左 透析 心肌应变 

分 类 号：R692[医药卫生—泌尿科学] R44[医药卫生—外科学]