三维斑点追踪技术评价不同左室构型尿毒症患者左室收缩功能的应用价值  

Application value of three-dimensional speckle tracking imaging in the evaluation of left ventricular systolic function in uremic patients with different left ventricular configurations

作　　者：祁英香 陈晓菲 姜志荣[1] QI Yingxiang;CHEN Xiaofei;JIANG Zhirong(Department of Cardiac Ultrasound,Affiliated Hospital of Qingdao University,Shandong 266000,China)

机构地区：[1]青岛大学附属医院心脏超声科,山东省青岛市266000

出　　处：《临床超声医学杂志》2022年第6期411-416,共6页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨三维斑点追踪(3D-STI)技术评价肾移植前不同左室构型尿毒症患者左室整体收缩功能的临床应用价值。方法将85例拟行肾移植术的尿毒症患者根据不同左室构型分为4组:左室构型正常组19例(LVN组),左室向心性重构组24例(LV-CR组),左室向心性肥厚组19例(LV-CH组)和左室离心性肥厚组23例(LV-EH组),另选24例同期体检的健康成人为正常对照组。测量并比较各组左室整体圆周应变(GCS)、整体径向应变(GRS)及整体纵向应变(GLS)的差异。绘制受试者工作特征(ROC)曲线分析各应变参数评估尿毒症患者心肌重构的价值。随机选择15例患者,采用Bland-Altman法分析GLS、GRS、GCS在观察者内和观察者间的一致性。结果与正常对照组比较,尿毒症各组GLS均减低,LV-CH、LV-EH组GRS、GCS均减低(均P<0.05);与LVN组比较,LV-CH、LV-EH组GLS、GRS、GCS均减低(均P<0.05);与LV-CR组比较,LV-CH组GLS、GCS及LV-EH组GLS、GCS、GRS均减低(均P<0.05);与LV-CH组比较,LV-EH组GLS、GCS均减低(均P<0.05)。ROC曲线分析显示,以向心性重构为界,GRS、GLS、GCS评估尿毒症患者心肌重构的ROC曲线下面积分别为0.684、0.882、0.786,敏感性分别为58.1%、86.0%、76.7%,特异性分别为74.2%、84.8%、65.2%。一致性分析显示,GLS、GCS、GRS在观察者内和观察者间均有良好的一致性。结论3D-STI技术可以有效评估肾移植前不同左室构型尿毒症患者左室整体收缩功能,具有较好临床应用价值。Objective(3D-STI)technology in evaluating the overall left ventricular systolic function of uremic patients with different ventricular configurations before renal transplantation.Methods into four groups according to different left ventricular configurations:left ventricular normal geometric 19 cases(LVN group),left ventricular centripetal remodeling group 24 cases(LV-CR group),left ventricular centripetal hypertrophy 19 cases(LV-CH group)and left ventricular eccentric hypertrophy 23 cases(LV-EH group).Another 24 healthy subjects underwent physical examination at the same time were selected as the control group.The three-dimensional global strain parameters of left ventricle in each group were measured and compared,including global circumferential strain(GCS),global radial strain(GRS)and global longitudinal strain(GLS).The receiver operating characteristic(ROC)curve was drawn to analyze the value of strain parameters in evaluating myocardial remodeling in patients with uremia.15 patients were randomly selected,the Bland-Altman method was used to analyze the measurement consistency of GLS,GRS and GCS within and between observers.ResultsCompared with the control group,the GLS in the uremia group decreased,and the GRS,GCS decreased in the LV-CH group and LV-EH group(all P<0.05).Compared with the LVN group,the GLS,GRS,GCS decreased in the LV-CH group and LV-EH group(all P<0.05).Compared with the LV-CR group,the GLS,GCS,GRS decreased in the LV-CH group and LV-EH group(all P<0.05).Compared with the LV-CH group,GLS,GCS in the LV-EH group decreased(both P<0.05).ROC curve analysis showed that taking centripetal remodeling as cut-off value,the area under the curve of GRS,GLS and GCS were 0.684,0.882 and 0.786,with sensitivity of 58.1%,86.0%and 76.7%,specificity of 74.2%,84.8%and 65.2%,respectively.The consistency analysis showed that GLS,GCS and GRS had good consistency within and between observers.Conclusion evaluate the overall left ventricular systolic function of uremic patients with different ventricular configuration

关 键 词：超声心动描记术 斑点追踪 三维 尿毒症 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R541[医药卫生—内科学]