三维斑点追踪技术联合红细胞微粒评价Ⅳ型心肾综合征患者左室心肌功能  

Evaluation of left ventricular function in typeⅣcardiorenal syndrome by three-dimensional speckle tracking technique combined with erythrocyte-derived microparticles

作　　者：陈伟燕[1] 张华[2] CHEN Weiyan;ZHANG Hua(Department of ICU,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China;不详)

机构地区：[1]广州医科大学附属第二医院重症医学科,广州510260 [2]广州医科大学附属第二医院超声科,广州510260

出　　处：《实用医学杂志》2020年第19期2705-2708,共4页The Journal of Practical Medicine

基　　金：广东省教育厅科研项目(编号:2017KQNCX170);广州医科大学附属第二医院2018年新技术、新业务临床研究与应用项目(编号:2018-XJS-E-05)。

摘　　要：目的探讨通过三维斑点追踪技术(3D-STE)及红细胞微粒(ErMPs)评价Ⅳ型心肾综合征(CRS)患者左室心肌运动的应用价值。方法选择2018年6月至2019年6月在我院就诊的31例Ⅳ型CRS患者(CRS组)、22例慢性心力衰竭患者(CHF组),30例健康成人(对照组),利用3D-STE测量三组中心肌应变及旋转角度,并通过流式细胞仪定量分析ErMPs,比较三组的组间差异性。结果CHF组的NT-pro-BNP水平较其余两组明显升高。ErMPs在CHF组和CRS组均升高,但两组间差异不明显(P>0.05)。CRS组室间隔增厚、左室舒张末和收缩末容积增大、左室射血分数减小,且较其余两组均有统计学差异(P<0.05)。与对照组比较,CRS组与CHF组中左室整体纵向应变、径向应变、圆周应变、面积应变、旋转及扭转角度均明显下降(P<0.05),但两组间比较差异不明显(P>0.05)。结论3D-STE及ErMPs能反映Ⅳ型CRS患者左室心肌运动受损情况,为早期正确评估Ⅳ型CRS患者左心功能提供重要参考价值。Objective To explore the value of three-dimensional speckle tracking echocardiography(3D-STE)and erythrocyte-derived microparticles(ErMPs)in assessing left ventricular myocardial motion in patients with typeⅣcardiorenal syndrome(CRS).Methods 31 patients with typeⅣCRS(CRS group)and 22 patients with chronic heart failure(CHF group)admitted to our hospital,together with 30 healthy adults(control group)from June 2018 to June 2019 were enrolled in the study.3D-STE was used to measure myocardial strain and rotation angle,and flow cytometer was used to quantitatively analyze the level of ErMPs.Results The blood urea nitrogen and creatinine in CRS group were significantly higher than those in the other two groups(P<0.05).The level of ErMPs was higher in the CHF and CRS group but without significant difference(P>0.05).As compared with the other two groups,the interventricular septum in the CRS group was significantly thicker,the left ventricular end-systolic volume and left ventricular end-diastolic volume were significantly larger and the left ventricular ejection fraction was significantly smaller(P<0.05).Compared with the control group,global longitudinal strain,global circumferential strain,global radial strain,global area strain,rotation and torsion of the left ventricles were significantly decreased in CRS and CHF group(P<0.05),but there was no significant difference between the two groups(P>0.05).Conclusion 3D-STE and ErMPs can reflect the damage of left ventricular motion in patients with typeⅣCRS,and they can be valuable for evaluating left ventricular function.

关 键 词：三维斑点追踪技术 红细胞微粒 Ⅳ型心肾综合征 慢性肾脏疾病 心血管疾病 心肌功能 

分 类 号：R540.4[医药卫生—心血管疾病]