峰值应变离散度评价慢性肾脏病患者左室收缩同步性的研究  

Evaluation of left ventricular systolic synchrony in patients with chronic kidney disease by peak strain dispersion

作　　者：季翔 李国杰 冯慧俊 张霞 JI Xiang;LI Guojie;FENG Huijun;ZHANG Xia(Department of Ultrasound Medical,the First Affiliated Hospital of Wannan Medical College,Anhui 241002,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院超声医学科,安徽省芜湖市241002

出　　处：《临床超声医学杂志》2022年第1期67-70,共4页Journal of Clinical Ultrasound in Medicine

基　　金：安徽省2017年公益性技术应用研究联动计划项目(1704f0804048);2020年芜湖市科技计划项目(2020ms3-5)。

摘　　要：目的探讨峰值应变离散度(PSD)评价慢性肾脏病(CKD)患者左室收缩同步性的临床应用价值。方法选取我院收治的CKD患者96例,根据肾小球滤过率(GFR)水平进行分组:GFR 30~89 ml/min者50例为A组,GFR<30 ml/min者46例为B组,另选取同期健康成人50例为对照组。各组均行二维经胸超声心动图检查获取常规超声心动图参数,然后采集连续3个心动周期的左室心尖四腔、三腔、两腔观二维动态图像,获得左室PSD和左室整体纵向应变(LVGLS),比较各组上述参数的差异,分析PSD与LVGLS的相关性,检验PSD在观察者内和观察者间的重复性。结果B组左室舒张末期内径指数、左室收缩末期内径指数、左室后壁厚度、左室舒张末期容积指数、左室收缩末期容积指数、左室相对室壁厚度和左室质量指数均高于对照组和A组,差异均有统计学意义(均P<0.05);A组上述参数与对照组比较,差异均无统计学意义。对照组、A组、B组PSD呈逐渐增大趋势,LVGLS呈逐渐减小趋势,各组间两两比较差异均有统计学意义(均P<0.05)。相关性分析显示,PSD与LVGLS呈负相关(r=-0.91,P<0.01)。PSD在观察者内和观察者间均有良好的重复性。结论PSD可早期、定量评价CKD患者左室收缩同步性,具有一定的临床应用价值。Objective To investigate the clinical value of peak strain dispersion(PSD)in evaluating left ventricular systolic synchrony in patients with chronic kidney disease(CKD).Methods Totally 96 patients with CKD were selected in our hospital,the patients were divided into two groups according to the glomerular filtration rate(GFR)level:50 cases with GFR 30~89 ml/min(group A),and 46 cases with GFR<30 ml/min group(group B),and 50 healthy people during the same period were selected as the control group.All groups underwent transthoracic two-dimensional echocardiography,the parameters of conventional echocardiography were measured,the two-dimensional dynamic images of apical four chamber and three chamber,and two chamber views of left ventricular for three consecutive cardiac cycles were collected.The left ventricular PSD and left ventricular global longitudinal strain(LVGLS)were obtained,the differences of the above parameters were compared,and the correlation between PSD and LVGLS was analyzed,and the reproducibility of PSD in inter-and intra-between observers was examined.ResultsThe left ventricular end-diastolic diameter index,left ventricular end-systolic diameter index,left ventricular posterior wall thickness,end-diastolic ventricular septal thickness,left ventricular end-diastolic volume index,left ventricular end-systolic volume index,left ventricular relative wall thickness,and left ventricular mass index of group B were higher than those of the control group and group A,and the differences were statistically significant(all P<0.05).There were no significant differences in the above parameters between group A and the control group.PSD gradually increased from control group to group A and then to group B,and the difference between each two groups were statistically significant(all P<0.05).LVGLS gradually decreased from control group to group A and then to group B,and the difference between each two groups were statistically significant(all P<0.05).Correlation analysis showed that PSD was negatively correlated with

关 键 词：超声心动描记术 峰值应变离散度 慢性肾脏病 心室功能 左 同步性 

分 类 号：R540.45[医药卫生—心血管疾病]