二维斑点追踪显像和实时三维超声心动图测量对慢性肾脏病患者左心房容积及功能的预测  

Prediction of Left Atrial Volume and Function in Patients with Chronic Kidney Disease by Two-dimensional Speckle Tracking Imaging and Real-time Three-dimensional Echocardiography

作　　者：何攀[1] 曹慧霞[1] 刘冰[1] 邵凤民[1] He Pan;Cao Huixia;Liu Bing;Shao Fengmin(Department of Nephrology, Henan Provincial People’s Hospital, Zhengzhou 450003, China)

机构地区：[1]河南省人民医院肾内科,郑州450003

出　　处：《成都医学院学报》2022年第1期25-28,共4页Journal of Chengdu Medical College

基　　金：河南省医学科技攻关计划省部共建项目(No:SBGJ2018062)。

摘　　要：目的探讨二维斑点追踪显像(2D-STI)和实时三维超声心动图(RT-3DE)测量左房最大容积指数(LAVImax)、左房最小容积指数(LAVImin)、左房前后径(LAd)和左房长轴径(Lx)对慢性肾病患者左心房容积及功能的预测价值。方法选取2018年1月至2020年1月河南省人民医院诊断并进行治疗的慢性肾病患者120例作为研究对象,另选取同期健康体检的120例志愿者作为对照组。所有研究对象均进行2D-STI和RT-3DE检查,比较两组患者超声指标、左房应变及应变率和容积指数,分析不同严重程度患者容积指数的差异。结果试验组二尖瓣口舒张早期左室快速充盈峰(e)、二尖瓣环组织的舒张早期波峰(e′)和e/e′均低于对照组(P<0.001),试验组左心室的射血分数(LVEF)水平低于对照组(P<0.001);试验组左房纵向峰值应变(Ss)、舒张晚期峰值应变(Sa)、舒张早期峰值应变(Se)、左房纵向峰值应变率(SRs)、舒张晚期峰值应变率(SRa)、舒张早期峰值应变率(SRe)均低于对照组(P<0.001);试验组LAVImin、LAVImax、LAd、Lx均高于对照组(P<0.001);不同严重程度慢性肾病患者的LAVImin、LAVImax、LAd、Lx比较,差异有统计学意义(P<0.001)。结论2D-STI和RT-3DE测量LAVImax、LAVImin、LAd、Lx对慢性肾脏病患者左心房容积及功能的预测价值较好。Objective To investigate the predictive value of left atrial maximum volume index(LAVImax),left atrial minimum volume index(LAVImin),left atrial diameter(LAd)and long axis diameter of left atrial(Lx)measured by two-dimensional speckle tracking imaging(2D-STI)and real-time three-dimensional echocardiography(RT-3DE)for left atrial volume and function in patients with chronic kidney disease(CKD).Methods A total of 120 CKD patients diagnosed and treated in Henan Provincial People’s Hospital from January 2018 to January 2020 were selected as the research subjects.Another 120 healthy volunteers who underwent physical examination during the same period were selected as the control group.All subjects were examined by 2D-STI and RT-3DE.Ultrasound index,left atrial strain and strain rate,volume index were compared between the two groups.And the differences of volume index between patients with different stages were analyzed.Results Left ventricular rapid filling peak in early diastolic mitral valve(e),early diastolic peak in mitral annulus(e′)and e/e′in the experimental group were lower than those in the control group(P<0.001).Left ventricular ejection fraction(LVEF)level in the experimental group was lower than that in the control group(P<0.001).Left atrial longitudinal peak strain(Ss),late diastolic peak strain(Sa),early diastolic peak strain(Se),left atrial longitudinal peak strain rate(SRs),late diastolic peak strain rate(SRa),and early diastolic peak strain rate(SRe)in the experimental group were all lower than those in the control group(P<0.001).LAVImin,LAVImax,LAd and Lx in the experimental group were higher than those in the control group(P<0.001).LAVImin,LAVImax,LAd and Lx in patients with different severity of CKD showed statistically significant difference(P<0.001).Conclusion LAVImax,LAVImin,LAd and Lx measured by 2D-STI and RT-3DE have good predictive value on left atrial volume and function in CKD patients.

关 键 词：二维斑点追踪显像 实时三维超声心动图测量 左房最大容积指数 左房最小容积指数 左房前后径 左房长轴径 慢性肾脏病 

分 类 号：R459.3[医药卫生—治疗学]