三维斑点追踪成像技术定量评价肾移植受者术后左心室整体应变  

Three-dimensional speckle tracking imaging for quantitative evaluation of left ventricular global strain in renal transplant recipients

作　　者：唐君仪 隋明星 奚佳颖[1] 朱霞玲 蔡珠虹[1] 金修才[1] Tang Junyi;Sui Mingxing;Xi Jiaying;Zhu Xialing;Cai Zhuhong;Jin Xiucai(Department of Ultrasound,Changhai Hospital of Shanghai,Shanghai 200433,China)

机构地区：[1]上海长海医院超声科,200433

出　　处：《器官移植》2021年第4期458-464,共7页Organ Transplantation

基　　金：上海市科学技术委员会科研计划项目(19ZR1478200)。

摘　　要：目的探讨采用三维斑点追踪成像(3D-STI)技术定量评价肾移植受者术后3个月内左心室整体应变的应用价值。方法选取34例肾移植受者,分别于术前、术后7 d、术后1个月、术后3个月收集受者的血压、血清肌酐和他克莫司血药浓度等资料,同时对受者行常规超声心动图和3D-STI检查,收集受者超声心动图检查参数[左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)]和3D-STI检查参数[左心室整体纵向峰值应变(GPLS)、整体圆周峰值应变(GPCS)、整体径向峰值应变(GPRS)及整体面积峰值应变(GPAS)]。比较受者术前、术后7 d、术后1个月、术后3个月上述指标的变化,分析应用3D-STI技术定量评价肾移植受者术后3个月内左心室整体应变的变化特点及其应用价值。结果肾移植受者术前至术后3个月内各时间点间LVEF和GPCS比较,差异均无统计学意义(均为P>0.05)。术前至术后3个月内各时间点间LVEDV、LVESV、GPLS、GPAS和GPRS比较,差异均有统计学意义(均为P<0.001)。GPLS、GPAS、GPRS在术后1个月内呈连续下降趋势,术后3个月有所上升但仍低于术前水平。结论应用3D-STI技术能够敏感地发现肾移植受者术后LVEF未见明显改变时左心室整体应变的改变,与常规超声心动图比较,3D-STI可以更准确地评价肾移植受者术后左心室整体应变的变化特点。Objective To evaluate the application value of three-dimensional speckle tracking imaging(3 D-STI)in quantitatively evaluating the left ventricular global strain in recipients within 3 months after renal transplantation.Methods Clinical data including blood pressure,serum creatinine and tacrolimus blood concentration of 34 renal transplant recipients were collected before operation,7 d,1 month and 3 months after operation,respectively.Meanwhile,conventional echocardiography and 3 D-STI examination were performed.Echocardiographic parameters[left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)and left ventricular ejection fraction(LVEF)]and 3 D-STI parameters[left ventricular global peak longitudinal strain(GPLS),global peak circumferential strain(GPCS),global peak radial strain(GPRS)and global peak area strain(GPAS)]of recipients were collected.The changes of these parameters before operation,7 d,1 month and 3 months after operation were statistically compared.The changing characteristic and application value of 3 D-STI in quantitatively evaluating the left ventricular global strain in recipients within 3 months after renal transplantation were evaluated.Results LVEF and GPCS did not significantly differ at different time points(all P>0.05),whereas LVEDV,LVESV,GPLS,GPAS and GPRS significantly differed at different time points from preoperative to within postoperative 3 months(all P<0.001).GPLS,GPAS and GPRS trended to decline within postoperative 1 month,and slightly increased at 3 months after operation,which was still lower than the preoperative levels.Conclusions Application of 3 D-STI may sensitively detect the changes of left ventricular global strain in recipients after renal transplantation when no significant variations are observed in postoperative LVEF.Compared with conventional echocardiography,3 D-STI may more accurately evaluate the changes of left ventricular global strain in recipients after renal transplantation.

关 键 词：三维斑点追踪成像(3D-STI) 肾移植 左心室射血分数(LVEF) 超声心动图 左心室整体应变 左心室舒张末期容积(LVEDV) 左心室收缩末期容积(LVESV) 他克莫司 整体纵向峰值应变(GPLS) 整体径向峰值应变(GPRS) 整体面积峰值应变(GPAS) 

分 类 号：R617[医药卫生—外科学] R540.45[医药卫生—临床医学]