压力-应变环对肾移植患者左心室做功的价值  

Study on left ventricular work in renal transplantation patients by pressure strain loop technique

作　　者：李庆 李小燕 牟芸[1] 贺芬宜 郑哲岚[1] LI Qing;LI Xiaoyan;MOU Yun;HE Fenyi;ZHENG Zhelan(Department of Echocardiography Center,the First Affiliated Hospital Zhejiang University School of Medicine,Hangzhou 310003,China)

机构地区：[1]浙江大学医学院附属第一医院心血管超声中心,杭州310003 [2]宁波市医疗中心李惠利医院 [3]宁波市医疗中心李惠利医院病案室 [4]宁波市医疗中心李惠利医院超声科

出　　处：《浙江医学》2023年第3期245-250,共6页Zhejiang Medical Journal

基　　金：浙江省自然科学基金项目(LSD19H180002)

摘　　要：目的探讨压力-应变环(PSL)对肾移植患者左心室做功的应用价值。方法选取2021年10月至2022年1月浙江大学医学院附属第一医院的肾移植患者76例,根据肾源分为亲属组16例和非亲属组60例;根据移植前透析龄分为低透龄组37例和高透龄组39例;根据左心室构型分为正常构型组29例、向心性肥厚组10例、向心性重构组11例和离心性肥厚组26例;根据血压分为血压正常组38例和高血压组38例。另选取同期健康体检者48名作为对照组。应用PSL获取两组对象的左心室心肌做功参数,包括心肌整体做功指数(GWI)、整体有用功(GCW)、整体无用功(GWW)、整体做功效率(GWE),比较两组间及不同亚组间的差异,寻找影响肾移植患者心肌做功的因素,并绘制ROC曲线寻找左心室心肌受损的最佳诊断参数。结果移植组与对照组间左心室射血分数(LVEF)差异无统计学意义(P>0.05),移植组GWW高于对照组,GWE低于对照组(均P<0.05)。进一步在不同亚组内比较,心肌做功参数GWW在不同的移植前透析龄、左心室构型、血压亚组间比较差异均有统计学意义(均P<0.05),GWE在不同的移植前透析龄及左心室构型亚组间比较差异均有统计学意义(均P<0.05)。相关性分析结果显示,GWE与GLS绝对值呈正相关(r=0.667,P<0.01),GWW与其呈负相关(r=-0.539,P<0.01)。ROC曲线分析显示,GWE诊断左心室心肌受损的效能较好,当GWE<95.5%时,预测左心室心肌受损的灵敏度为0.829,特异度为0.896。结论PSL可为肾移植患者左心室做功提供灵敏可靠的定量指标,能更客观反映左心室心肌受损情况,为临床诊治提供可靠依据。Objective To investigate the application value of pressure strain loop on left ventricular work in renal transplantation patients.Methods Seventy-six kidney transplantation patients from the First Affiliated Hospital Zhejiang University School of Medicine from October 2021 to January 2022 were selected.They were divided into relative group(16 cases)and non-relative group(60 cases)according to kidney source.According to the dialysis age before transplantation,the patients were divided into low(37 cases)and high dialysis age groups(39 cases).According to left ventricular configuration,they were divided into normal configuration group(29 cases),centripetal hypertrophy group(10 cases),centripetal remodeling group(11 cases)and centripetal hypertrophy group(26 cases).According to blood pressure,they were divided into normal blood pressure group(38 cases)and hypertension group(38 cases).Forty-eight healthy subjects were selected as control group.PSL was used to obtain the myocardial work parameters of the left ventricle.Including global myocardial work index(GWI),global constructive work(GCW),global myocardial wasted work(GWW),and global myocardial work efficiency(GWE),The differences between the two groups and different subgroups were compared to find the factors affecting the myocardial work of renal transplantation patients,and the ROC curve was drawn to find the best diagnostic parameters of left ventricular myocardial damage.Results There was no significant difference in LVEF between the transplantation group and the control group(P>0.05),and the difference in myocardial work was significant(P<0.05).The GWW of the transplantation group was higher than that of the control group,and the GWE was lower than that of the control group.Further comparison among different subgroups showed that there were no significant differences in LVEF and GLS among different subgroups,while myocardial work parameter GWW had statistical significance among different subgroups of dialysis age before transplantation,left ventricular configu

关 键 词：心肌做功 压力-应变环 肾病 肾移植 

分 类 号：R699.2[医药卫生—泌尿科学]