实时三维超声自动左房定量技术评价左室射血分数保留的尿毒症血液透析患者左房功能  

Assessment of left atrial function in uremic hemodialysis patients with preserved left ventricular ejection fraction by real-time three-dimensional ultrasound automatic left atrial quantification

作　　者：赵丽[1] 苏璇[1] 现丽妮[1] 陈剑[1] 宋晓蕾[1] 丁云川[1] 王庆慧[1] ZHAO Li;SU Xuan;XIAN Lini;CHEN Jian;SONG Xiaolei;DING Yunchuan;WANG Qinghui(Department of Ultrasound,the Affiliated Yan’an Hospital of Kunming Medical University,Kunming 650051,China)

机构地区：[1]昆明医科大学附属延安医院超声医学科,云南省心血管疾病重点实验室,昆明市650051

出　　处：《临床超声医学杂志》2021年第8期591-595,共5页Journal of Clinical Ultrasound in Medicine

基　　金：云南省卫生科技计划项目(2017NS331)。

摘　　要：目的应用实时三维超声自动左房定量(LAQ)技术评估左室射血分数(LVEF)保留的尿毒症血液透析患者左房功能。方法选取我院LVEF正常的尿毒症血液透析患者37例(尿毒症组)及同期健康体检者34例(正常对照组),两组均行常规超声检查和LAQ分析获取左室舒张末内径(LVEDd)、室间隔舒张末厚度(LVSd)、左室后壁舒张末厚度(LVPWd)、LVEF、二尖瓣口舒张早期和晚期血流速度峰值(E和A)、二尖瓣环舒张早期室间隔及左室侧壁组织运动速度(e’)、E/A、E与室间隔e’和左室侧壁e’均值的比值(E/e’)、肺毛细血管楔压(ePCWP)、肺动脉收缩压(PASP)、左房前后径(LAD1)、左房左右径(LAD2)、左房上下径(LAD3)、左房最大容积(LAVmax)、左房最小容积(LAVmin)、左房射血分数(LAEF)、左房收缩前容积(LAVpreA)、左房最大容积指数(LAVImax)、左房射血容量(LAEV)、储存期纵向应变(LASr)、管道期纵向应变(LAScd)、收缩期纵向应变(LASct)、储存期周向应变(LASr-c)、管道期周向应变(LAScd-c)及收缩期周向应变(LASct-c),比较两组上述参数的差异;分析应变参数与LAEF、LAVImax的相关性。结果与正常对照组比较,尿毒症组LVEDd、IVSd、LVPWd、A、E/e’、ePCWP、PASP均增加,LVEF、E/A、室间隔e’和左室侧壁e’均降低,差异均有统计学意义(均P<0.05);两组E峰比较差异无统计学意义。与正常对照组比较,尿毒症组二维参数LAD1、LAD2、LAD3、LAVmax、LAVmin和三维参数LAVmin、LAVmax、LAVpreA、LAVImax、LAEV均增加,LAEF降低,差异均有统计学意义(均P<0.05);应变参数LASr、LAScd、LASct、LASr-c、LAScd-c均降低,差异均有统计学意义(均P<0.05);两组LASct-c比较差异无统计学意义。LAEF与LASr、LASr-c均呈正相关(均P<0.05),与LAScd、LASct、LAScd-c均呈负相关(均P<0.05),与LASct-c无相关性;LAVImax与LASr、LASr-c均呈负相关(均P<0.05),与LAScd、LAScd-c均呈正相关(均P<0.05),与LASct、LASct-c无相关性。结�Objective ventricular ejection fraction(LVEF)by real-time three-dimensional ultrasound automatic left atrial quantification(LAQ).Methods enrolled in the study.Left ventricle end diastolic dimensions(LVEDd),interventricular septum diastolic thickness(IVSd),Left ventricle posterior wall diastolic thickness(LVPWd),LVEF,Peak E and A velocity,e’velocities on the septal and lateral mitral annulus,E/A,E/e’,pulmonary capillary wedge pressure(ePCWP),pulmonary artery systolic pressure(PASP),anteroposterior diameter(LAD1),medial-later diameter(LAD2),superior-inferior diameter(LAD3),left atrial maximum volume(LAVmax),left atrial minimum volume(LAVmin),left atrial ejection fraction(LAEF),left atrial volume at onset of contraction(LAVpreA),left atrial maximum volume index(LAVImax),left atrial ejection volume(LAEV),longitudinal strain(LASr)in reservoir phase and circumferential strain(LASr-c),longitudinal strain(LAScd)in conduit phase and circumferential strain(LAScd-c),longitudinal strain(LASct)in systolic phase and circumferential strain(LASct-c)were obtained by conventional ultrasonography and LAQ.The results of two groups were compared and analyzed,and the correlation between the strain parameters and LAEF and LAVImax were analyzed.ResultsCompared with the control group,the LVEDd,IVSd,LVPWd,A,E/e’,ePCWP,PASP in the case group were increased,while LVEF,E/A,e’on the septal and lateral mitral annulus were decreased,and the differences were statistically significant(all P<0.05).There was no significant difference in E between two groups.In the case group,two-dimensional parameters LAD1,LAD2,LAD3,LAVmax,LAVmin,and three-dimensional parameters LAVmin,LAVmax,LAVpreA,LAVImax,LAEV were significantly increased,while LAEF and strain parameters,including LASr,LAScd,LASct,LASr-c,LAScd-c were significantly decreased(all P<0.05).And LASct-c had no significant difference between two groups.LAEF had a positive correlation with LASr and LASr-c,and had a negative correlation with LAScd,LASct and LAScd-c(all P<0.05),but had no correlat

关 键 词：超声心动描记术 三维 实时 自动定量技术 尿毒症 应变 心房功能 左 

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