慢性肾脏病3~5期非透析患者心房电机械延迟时间改变及影响因素  

Changes and influencing factors of changes of atrial electromechanical delay time in non-dialysis patients with stage 3 to 5 chronic kidney disease

作　　者：王晴 陈勇 包萍 杨菲 袁静 WANG Qing;CHEN Yong;BAO Ping;YANG Fei;YUAN Jing(Medical College of Yangzhou University,Yangzhou,Jiangsu,225001;Department of Functional Examination,Clinical Medical College of Yangzhou University,Yangzhou,Jiangsu,225001)

机构地区：[1]扬州大学医学院,江苏扬州225001 [2]扬州大学临床医学院功能检查科,江苏扬州225001

出　　处：《实用临床医药杂志》2023年第15期68-72,共5页Journal of Clinical Medicine in Practice

摘　　要：目的 采用组织多普勒成像(TDI)评估慢性肾脏病(CKD)3~5期非透析患者的心房电机械延迟(AEMD)时间及其影响因素。方法 选取60例健康者作为对照组,104例CKD 3~5期非透析患者作为病例组,2组均进行超声心动图检查。通过Pearson相关系数评估AEMD时间与其他参数和指标的相关性。结果 与对照组比较,病例组的机电耦合时间(PA)外侧、PA间隔侧、PA三光瓣、左心房电机械延迟(EMD)及心房间EMD时间延长,差异有统计学意义(P<0.05)。病例组PA间隔侧与甘油三酯呈正相关(P<0.05);左心房EMD时间和心房间EMD时间与收缩压、舒张期室间隔厚度(IVSd)、左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)、舒张期左心室后壁厚度(LVPWTd)及二尖瓣环舒张早期流速/心肌舒张早期速度(E/e′)呈正相关,与估算肾小球滤过率(eGFR)呈负相关(P<0.05)。结论 CKD 3~5期非透析患者的PA外侧、PA间隔侧、左心房EMD及心房间EMD时间显著延长,SBP、甘油三酯、心肌结构、E/e′及eGFR可能是该类患者AEMD时间延长的影响因素。Objective To evaluate the atrial electromechanical delay(AEMD)time in non-dialysis patients with chronic kidney disease(CKD)in stage 3 to 5 by tissue Doppler imaging(TDI)and its influencing factors.Methods Sixty healthy subjects were selected as control group,and 104 non-dialysis patients in stage 3 to 5 CKD were selected as case group,all of whom underwent echocardiography.The correlations of AEMD time with other parameters and indicators were evaluated by Pearson′s correlation coefficient.Results Compared with the control group,the electromechanical coupling time(PA)lateral,septal PA,PA tricuspid valve the left atrial electromechanical delay time(EMD)and interatrial EMD time in the case group were significantly prolonged(P<0.05).The PA interval was positively correlated with triglyceride(P<0.05);the left atrial EMD time and interatrial EMD time were positively correlated with systolic blood pressure,diastolic ventricular septal thickness(IVSd),left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd),left ventricular end-diastolic posterior wall thickness(LVPWTd)as well as the early mitral ring diastolic flow rate/early myocardial diastolic velocity(E/e′),and negatively correlated with estimated glomerular filtration rate(eGFR)(P<0.05).Conclusion The PA lateral,PA interval,left atrium EMD time and interatrial EMD time are significantly prolonged in patients.The SBP,triglyceride,myocardium structure,E/e′and eGFR may be the influencing factors for the prolonged AEMD time in these patients.

关 键 词：超声心动图 心房电机械延迟 慢性肾脏病 组织多普勒成像 机电耦合时间 

分 类 号：R692[医药卫生—泌尿科学] R445.1[医药卫生—外科学]