基于速度向量成像技术的慢性肾小球肾炎患者左心房功能与运动同步性的相关性研究  

Correlation study between left atrial function and motor synchrony in patients with chronic glomerulonephritis based on velocity vector imaging

作　　者：洪俊蓉 张平洋[2] 陆怡朴 秦庆庆 刘勤 HONG Junrong;ZHANG Pingyang;LU Yipu;QIN Qingqing;LIU Qin(Department of Functional Examination,Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine(Nanjing Traditional Chinese Medicine Hospital),Nanjing 210006,China;Department of Cardiovascular Ultrasound,Nanjing Hospital Affiliated to Nanjing Medical University(Nanjing First Hospital),Nanjing 210006,China)

机构地区：[1]南京中医药大学附属南京中医院(南京市中医院)功能检查科,江苏南京210006 [2]南京医科大学附属南京医院(南京市第一医院)心血管超声科,江苏南京210006

出　　处：《中国现代医生》2022年第33期5-8,14,共5页China Modern Doctor

基　　金：江苏省卫健委医学科研重点项目(ZD2021048)。

摘　　要：目的利用速度向量成像技术(velocity vector imaging,VVI)分析慢性肾小球肾炎(chronic glomerulonephritis,CGN)患者左心房功能和储备期运动同步性改变及两者相关性。方法选取2020年12月至2021年7月在南京市中医院经胸心脏超声检查的52例CGN患者,分为A组(n=26,2~3期)和B组(n=26,4~5期),另选取健康志愿者50名为C组(对照组),采用VVI获得左心房功能指标和储备期运动同步性指标,比较三组各项指标的差异并分析两者的相关性。结果①三组除血肌酐、收缩压(systolic blood pressure,SBP)比较差异有统计学意义(P<0.05)外,余一般临床资料比较差异无统计学意义(P>0.05);②三组的左心房功能指标比较差异有统计学意义(P<0.05);③三组的左心房顶部峰值时间(peak time of left atrial roof,TP-LAR)比较差异无统计学意义(P>0.05),三组的平均左心房侧壁峰值时间(peak time of left atrial lateral wall,TP-LALW)、房间隔峰值时间(peak time of atrial septum,TP-AS)、任意两节段应变率最大峰值时间差(maximum peak time difference of strain rate of any two segments,TSR-MAX)比较,差异有统计学意义(P<0.05);④收缩期峰值应变率(peak systolic strain rate,SRS)、舒张早期峰值应变率(early diastolic peak strain rate,SRE)、舒张末期峰值应变率(late diastolic peak strain rate,SRA)与mTP-LALW、mTP-AS、mTSR-MAX呈负相关(P<0.05),与mTP-LAR无相关性(P>0.05)。结论CGN患者左心房的储存、通道和泵血功能随肾功能不全进展减低;左心房储备期mTP-LALW、mTP-AS及mTSR-MAX随肾功能不全进展增加,存在左房运动非同步性;左房功能与储备期运动同步性具有相关性,左房功能损害伴随着电传导异常。Objective To analyze the changes of left atrial function and motor synchronization in reserve period in patients with chronic glomerulonephritis(CGN)and their correlation by appling velocity vector imaging(VVI).Methods Fifty two patients with CGN underwent transthoracic echocardiography in Nanjing Traditional Chinese Medicine Hospital from December 2020 to July 2021 were selected and divided into group A(n=26,stage 2~3),group B(n=26,stage 4~5),and another 50 healthy volunteers as group C(control group).The left atrial function index and reserve motor synchronization index were obtained by VVI.The differences of these indexes among the three groups of participants were compared and the correlation between them were analyzed.Results①There was no significant difference(P>0.05)in clinical data among the three groups excepted for the difference in the mean values of serum creatinine and SBP.②There were significant differences in left atrial function among the three groups(P<0.05).③There was no significant difference in mTP-LAR among the three groups(P>0.05),but there were significant differences in mTP-LALW mTP-AS and mTSR-MAX(P<0.05).④mSRS and mSRA were negatively correlated with mTP-LALW mTP-AS and mTSR-MAX(P<0.05),but not with mTP-LAR(P>0.05).Conclusion The storage,channel and pumping function of left atrium in CGN patients decreased with the progression of renal insufficiency.During the left atrial reserve period,mTP-LALW mTP-AS and mTSR-MAX increased with the progression of renal insufficiency,and left atrial motion asynchrony existed;There is a correlation between left atrial function and motor synchrony in reserve period.Left atrial function damage is accompanied by abnormal electrical conduction.

关 键 词：速度向量成像技术 慢性肾小球肾炎 左心房功能 运动同步性 应变率 

分 类 号：R692[医药卫生—泌尿科学]