超声心动图对LVEF正常ESRD患者左心功能和心室重构的研究价值  

Value of echocardiography on left heart function and ventricular remodeling in ESRD patients with normal LVEF

作　　者：黄亚芳 黄定伟 许厚本 HUANG Ya-fang;HUANG Ding-wei;XU Hou-ben(Department of Function,First Affiliated Hospital of Hunan Traditional Chinese Medical College(Hu′nan Provincial Hispital of Traditional Chinese Medicine),Zhuzhou,Hu′nan,421000,China)

机构地区：[1]湖南中医药高等专科学校附属第一医院(湖南省中医医院)功能科,湖南株洲421000

出　　处：《心血管康复医学杂志》2022年第2期199-203,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨超声心动图描记术对LVEF正常的终末期肾病(ESRD)患者左心功能和心室重构的研究价值。方法:选择2019年4月-2020年4月首次于我院进行透析治疗的LVEF正常的ESRD患者共104例作为ESRD组;同时选择年龄、性别匹配的50例健康体检者为健康对照组。采用超声心动图检测,比较两组心室收缩、舒张功能指标,Tei指数及血清N末端B型钠尿肽(NT-proBNP)、转化生长因子(TGF)-β1水平。结果:与健康对照组比较,ESRD组左室舒张末容积(LVEDV)[(102.68±9.73)ml比(118.28±29.01)ml]、左室收缩末容积(LVESV)[(33.06±4.71)ml比(41.09±12.88)ml]、左室整体舒张末容积(gLVEDV)[(74.87±10.13)ml比(93.70±11.51)ml]、左室整体收缩末容积(gLVESV)[(27.23±5.31)ml比(43.92±13.83)ml]、E[(69.78±17.36)cm/s比(81.16±23.97)cm/s]、A[(68.49±24.73)cm/s比(87.44±20.68)cm/s]、A’[(9.27±3.11)cm/s比(10.58±2.84)cm/s]、血清NT-proBNP[(158.60±31.49)pg/ml比(2838.09±650.88)pg/ml]、TGF-β1[(8.74±4.33)μg/L比(42.75±6.77)μg/L]水平和Tei指数[(0.36±0.04)比(0.42±0.12)]均显著升高,LVEF[(67.73±4.19)%比(62.55±5.41)%]、左室整体射血分数(gLVEF)[(64.22±3.80)%比(56.18±5.11)%]、E/A[(1.48±0.82)比(0.86±0.41)]、E’[(11.08±2.54)cm/s比(6.98±2.07)cm/s]、E’/A’[(1.16±0.81)比(0.71±0.23)]均显著降低,P均=0.001。结论:LVEF正常的ESRD患者存在左心室重构及功能减退,临床应重视此类患者的左心室重构及功能的全面评估。Objective:To explore value of echocardiography(ECG)on left heart function and ventricular remodeling in patients with end stage renal disease(ESRD)and normal LVEF.Methods:A total of 104 ESRD patients with normal LVEF,who received first dialysis therapy in our hospital from Apr 2019 to Apr 2020,were regarded as ESRD group;another 50 healthy subjects with corresponding age and gender were treated as healthy control group.Heart function was measured by ECG,ventricular systolic and diastolic function indexes,Tei index,serum levels of N terminal pro brain natriuretic peptide(NT-proBNP),transforming growth factor(TGF)β1 were compared between two groups.Results:Compared with healthy control group,there were significant rise in left ventricular end-diastolic volume(LVEDV)[(102.68±9.73)ml vs.(118.28±29.01)ml],left ventricular end-systolic volume(LVESV)[(33.06±4.71)ml vs.(41.09±12.88)ml],general LVEDV(gLVEDV)[(74.87±10.13)ml vs.(93.70±11.51)ml],general LVESV(gLVESV)[(27.23±5.31)ml vs.(43.92±13.83)ml],E[(69.78±17.36)cm/s vs.(81.16±23.97)cm/s],A[(68.49±24.73)cm/s vs.(87.44±20.68)cm/s],A’[(9.27±3.11)cm/s vs.(10.58±2.84)cm/s],serum levels of NT-proBNP[(158.60±31.49)pg/ml vs.(2838.09±650.88)pg/ml],TGF-β1[(8.74±4.33)μg/L vs.(42.75±6.77)μg/L]and Tei index[(0.36±0.04)vs.(0.42±0.12)],and significant reductions in LVEF[(67.73±4.19)%vs.(62.55±5.41)%],general LVEF(gLVEF)[(64.22±3.80)%vs.(56.18±5.11)%],E/A[(1.48±0.82)vs.(0.86±0.41)],E’[(11.08±2.54)cm/s vs.(6.98±2.07)cm/s]and E’/A’[(1.16±0.81)vs.(0.71±0.23)]in ESRD group,P=0.001 all.Conclusion:Left ventricular remodeling and functional decline exist in ESRD patients with normal LVEF.Attention should be paid to left ventricular remodeling and comprehensive function assessment in these patients.

关 键 词：超声心动描记术 肾病 心室重构 

分 类 号：R692[医药卫生—泌尿科学]