血流向量成像技术定量评估慢性肾脏病患者左室功能的临床价值  

Quantitative assessment of left ventricular function in patients with chronic kidney disease by vector flow mapping

作　　者：王伟[1] 白晖[1] 周金玲[1] 常青 王岳恒[1] WANG Wei;BAI Hui;ZHOU Jinling;CHANG Qing;WANG Yueheng(Department of Cardiac Ultrasound,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院心脏超声科,石家庄市050000

出　　处：《临床超声医学杂志》2021年第4期266-270,共5页Journal of Clinical Ultrasound in Medicine

基　　金：河北省卫生健康委青年科技课题(20210496)。

摘　　要：目的应用血流向量成像(VFM)技术分析慢性肾脏病患者左室能量损耗(EL)变化,探讨其评估慢性肾脏病患者左室功能受损的临床价值。方法选取慢性肾脏病患者61例,其中左室射血分数(LVEF)≥50%者42例(A组),LVEF<50%者19例(B组),另选取38例健康成人为正常对照组。应用VFM技术获取各组左室充盈早期、左房收缩期、等容收缩期及射血期平均EL(E-EL-ave、A-EL-ave、I-EL-ave及Ej-EL-ave)。比较各组上述参数的差异,绘制受试者工作特征曲线分析其诊断不同程度左室功能受损的诊断效能,分析各时相EL与常规超声参数的相关性。结果与正常对照组比较,A组各时相EL均升高,B组A-EL-ave升高,Ej-EL-ave降低,差异均有统计学意义(均P<0.05)。Ej-EL-ave在正常对照组、A组、B组表现为双相变化趋向。Ej-EL-ave对慢性肾脏病患者早期左室功能受损及LVEF<50%均有良好的诊断效能(曲线下面积分别为0.907、0.861,均P<0.001)。慢性肾脏病患者Ej-EL-ave与LVEF呈正相关(r=0.636,P<0.01)。结论VFM技术所测参数Ej-EL-ave可以作为评估慢性肾脏病患者左室泵功能效率的潜在新指标,有一定的临床应用价值。Objective To analyze the change characteristics of left ventricular energy loss(EL)in chronic kidney disease by vector flow mapping(VFM)technique,and to explore the clinical value of EL in quantitative evaluating left ventricular function in patients with chronic kidney disease.Methods Sixty-one patients with chronic kidney disease were selected in this study,including 42 patients with left rentricular ejection fraction(LVEF)≥50%in group A,19 patients with LVEF<50%in group B,38 healthy adults were enrolled as control group.Left ventricle average EL in early filling phase(E-EL-ave),atrial filling phase(A-EL-ave),isovolumic contraction period(I-EL-ave),and ejection phase(Ej-EL-ave)were acquired and calculated by VFM technique,and the differences of above parameters in each group were compared.Receiver operating characteristic curve was drawn to analyze the diagnostic efficacy of different degrees of left ventricular dysfunction.The relationship between EL in each phase and conventional ultrasound parameters were analyzed.Results Compared with the control group,EL in all phases of group A were increased,A-EL-ave was increased in group B,and Ej-EL-ave was decreased in group B.The differences were statistically significant(all P<0.05).Ej-EL-ave showed a biphasic trend in the control group,group A and group B.Ej-EL-ave had good diagnostic efficacy for early left ventricular function impairment and LVEF<50%in patients with chronic kidney disease(area were 0.907,0.861,respectively,both P<0.001).Ej-EL-ave was positively correlated with LVEF in the patients with chronic kidney disease(r=0.636,P<0.01).Conclusion The parameter of Ej-EL-ave measured by VFM technique can be used as a potential new indicator to evaluate the efficiency of left ventricular pump function in patients with chronic kidney disease,which has certain clinical value.

关 键 词：血流向量成像 心室功能 左 能量损耗 肾脏病 慢性 

分 类 号：R540.45[医药卫生—心血管疾病] R692.9[医药卫生—内科学]