二维斑点追踪成像与慢性肾病患者肾功能的关系  

Relationship Between Two-Dimensional Speckle Tracking Imaging and Renal Function in Patients with Chronic Kidney Disease

作　　者：宋钰[1] 吴秀琴[1] 陈建雄 郑长新[1] 杨晓凤 吴方芳 刘银萍 Song Yu;Wu Xiuqin;Chen Jianxiong;Zheng Changxin;Yang Xiaofeng;Wu Fangfang;Liu Yinping(Department of Ultrasound,Fujian Ningde Mindong Hospital,Ningde,Fujian 355000,China)

机构地区：[1]福建医科大学附属宁德市闽东医院超声科,福建省宁德市355000

出　　处：《中国超声医学杂志》2024年第9期1021-1025,共5页Chinese Journal of Ultrasound in Medicine

基　　金：宁德市自然科学基金项目(No.2023J15)。

摘　　要：目的探讨二维斑点追踪成像(2D-STI)与慢性肾病(CKD)患者肾功能的关系。方法选取确诊为CKD的患者137例,按照肾小球滤过率(eGFR)分为CDK1组[eGFR30~59mL/(min·1.73m^(2)),n=45]、CDK2组[eGFR<30mL/(min·1.73m^(2)),n=92],另选取性别、年龄匹配的健康志愿者50例为参照组。采集各组胸骨旁左心室短轴切面(包括底段水平、中间段水平、心尖段水平)、心尖左心室长轴(三腔、四腔、二腔心)切面的检查图像,获取左心室收缩期整体纵向应变(GLS)、整体圆周应变(GCS)。分析CKD患者2D-STI参数与肾功能的关系。结果3组2D-STI参数GLS(绝对值)及eGFR值比较,CDK2组<CDK1组<参照组,且CDK2组2D-STI参数GCS低于CDK1组、参照组(P<0.05)。Pearson相关分析显示,CKD患者2D-STI参数GLS、GCS与收缩压、尿酸、血肌酐、尿素氮、二尖瓣口舒张早期峰值流速/二尖瓣环室间隔及侧壁舒张早期运动速度峰值平均值(E/e')均呈负相关,与eGFR值均呈正相关(P<0.05)。回归分析显示,调整了收缩压、尿酸、血肌酐、尿素氮、E/e'等混杂因素干扰后,eGFR仍与GLS独立相关(β值=0.502,P<0.05);绘制受试者工作特征(ROC)曲线可知,GLS对CKD患者病情进展的预测价值良好,曲线下面积(AUC)为0.806。结论2D-STI测定的GLS与CKD患者肾功能独立相关,且对病情进展预测效能良好。Objective To investigate the relationship between two-dimensional speckle tracking imaging(2D-STI)and renal function in patients with chronic kidney disease(CKD).Methods A total of 137 patients diag-nosed with CKD were selected for the study.Based on the estimated glomerular filtration rate(eGFR),patients were divided into the CKD1 group[eGFR 30-59 mL/(min·1.73 m2),n=45]and the CKD2 group[eGFR<30 mL/(min·1.73 m2),n=92].Additionally,50 age-and sex-matched healthy volunteers were selected as the con-trol group.Images of the parasternal short-axis view of the left ventricle(including basal,mid,and apical levels)and the apical long-axis view(three-chamber,four-chamber,and two-chamber)were collected.Global longitudinal strain(GLS)and global circumferential strain(GCS)of the left ventricle during systole were obtained.The relationship be-tween 2D-STI parameters and renal function in CKD patients was analyzed.Results Comparison of 2D-STI parame-ters GLS(absolute value)and eGFR values among the three groups showed that CKD2 group<CKD1 group<control group,and the GCS in the CKD2 group was lower than that in the CKD1 group and the control group(P<0.05).Pearson correlation analysis indicated that 2D-STI parameters GLS and GCS in CKD patients were negatively correla-ted with systolic blood pressure,uric acid,serum creatinine,blood urea nitrogen,and early diastolic peak mitral ori-fice velocity/early diastolic velocity of the mitral annulus by tissue Doppler imaging(E/e'),while positively correlated with eGFR(P<0.05).Regression analysis showed that after adjusting for confounding factors such as systolic blood pressure,uric acid,serum creatinine,blood urea nitrogen,and E/e',eGFR remained independently associated with GLS(βvalue=0.502,P<0.05).The receiver operating characteristic(ROC)curve demonstrated that GLS had good predictive value for the progression of CKD,with an area under the curve(AUC)of 0.806.Conclusions GLS measured by 2D-STI is independently associated with renal function in CKD patients and has good predictiv

关 键 词：二维斑点追踪成像 左心室整体应变 慢性肾病 肾功能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R692[医药卫生—诊断学]