纵向应变及峰值应变离散度评价不同构型尿毒症患者左心室收缩功能及同步性  

Evaluation of left ventricular systolic function and synchronicity in patients with different configurations of uremia by longitudinal strain and peak strain dispersion

作　　者：田芳[1] 唐海霞[1] 邱杰 伍卓乐 景香香[1] 王超 TIAN Fang;TANG Haixia;QIU Jie;WU Zhuole;JING Xiangxiang;WANG Chao(Department of Ultrasound,Hainan General Hospital,Hainan Affiliated Hospital of Hainan Medical University,Haikou 570311,P.R.China;Department of Ultrasound,Hainan Hospital of Traditional Chinese Medicine,Haikou 570203,P.R.China)

机构地区：[1]海南省人民医院海南医学院附属海南医院超声科,海南海口570311 [2]海南省中医院超声科,海南海口570203

出　　处：《医学影像学杂志》2021年第8期1310-1314,共5页Journal of Medical Imaging

基　　金：海南省科技厅重点研发计划项目(编号:ZDYF2019179)。

摘　　要：目的探讨纵向应变及峰值应变离散度评价不同构型尿毒症患者左心室收缩功能及同步性的临床价值。方法选取尿毒症患者209例,根据左心室质量指数(LVMI)和相对室壁厚度(RWT)的国际标准将尿毒症患者分为四组:1)正常构型组;2)向心性重构组;3)向心性肥厚组;4)离心性肥厚组,同时选取40例健康体检者作为对照组,应用实时三平面自动功能成像技术测量各组间左心室纵向收缩应变值(GLPS)及峰值应变离散度(PSD),并进行组间及组内比较分析以及相关性分析。结果不同构型组中GLPS与PSD较对照组差异均有统计学意义(P<0.05),且组间比较差异均有统计学意义(P<0.05)。GLPS与BNP成正相关r=0.504(P=0.004),PSD与BNP成正相关r=0.458(P=0.01),GLPS与PSD成正相关r=0.538(P=0.002),GLPS及PSD与左心室射血分数(LVEF)无明显相关性(P>0.05)。结论GLPS及PSD可以早期、定量、准确评价不同构型尿毒症患者左心室心肌收缩功能及同步性变化。GLPS及PSD可作为临床诊断尿毒症患者心血管疾病发生的新指标。Objective To investigate the clinical value of longitudinal strain and peak strain dispersion in evaluating left ventricular systolic function and synchronicity in patients with different configurations of Uremia.Methods 209 uremic patients were divided into four groups according to the international standards of left ventricular mass index(LVMI)and relative wall thickness(RWT)1)normal configu-ration(NG)group;2)concentric remodeling(CR)group;3)concentric hypertrophy(CH)group;4)eccentric hypertrophy(EH)group,and 40 healthy subjects were selected as the control group.The global longitudinal peak strain(GLPS)and peak strain dispersion(PSD)of left ventricle were measured by real-time three-plane AFI technology.Results The differences between GLPS and PSD in different configuration groups were statistically significant(P<0.05),and the differences between groups were statistically significant(P<0.05).There was a positive correlation between GLPS and BNP(r=0.504,P=0.004),a positive correlation between PSD and BNP(r=0.458,P=0.01),a positive correlation between GLPS and PSD(r=0.538,P=0.002),and theer was no correlation between GLPS and LVEF,no correlation between PSD and LVEF(P>0.05).Conclusion GLPS and PSD can be used to evaluate left ventricular systolic function and synchrony in uremic patients with different configurations.GLPS and PSD can be used as a new indexes to diagnose cardiovascular disease in uremia patients.

关 键 词：尿毒症 纵向收缩峰值应变 超声心动图 峰值应变离散度 左心室功能 心肌 

分 类 号：R541[医药卫生—心血管疾病] R540.4[医药卫生—内科学]