二维斑点追踪联合三维超声定量评价慢性肾脏病患者左心室收缩功能受损  

Two-Dimensional Speckle Tracking Imaging Combined with Three-Dimensional Heart Model Evaluation of Left Ventricular Systolic Dysfunction in Patients with Chronic Kidney Disease

作　　者：刘银萍 吴秀琴[1] 许善玲 刘羽[1] 陈英[1] 宋钰[1] Liu Yinping;Wu Xiuqin;Xu Shanling;Liu Yu;Chen Ying;Song Yu(Fujian Medical University Affiliated 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,福建省宁德市355000

出　　处：《中国超声医学杂志》2024年第11期1272-1276,共5页Chinese Journal of Ultrasound in Medicine

基　　金：宁德市自然科学基金(No.2023J15)。

摘　　要：目的观察二维斑点追踪技术(2D-STI)联合三维超声全自动定量技术(3D-HM)评价慢性肾脏病(CKD)患者早期左心室收缩功能受损的价值。方法选取确诊的99例CKD患者为CKD组,另选取50例健康志愿者设为健康对照组。采集2组及不同CKD分期亚组患者二维斑点追踪技术(2D-STI)、三维超声全自动定量技术(3D-HM)检查参数,分析2D-STI、3D-HM参数单一、联合应用对CKD患者早期左心室功能受损的评估价值。结果CKD组整体纵向应变(GLS)绝对值、三维左心室射血分数(3D-LVEF)低于健康对照组,三维左心室收缩末期容积(3D-LVESV)、三维左心室舒张末期容积(3D-LVEDV)高于健康对照组,且随CKD分期增加,CKD患者GLS绝对值、3D-LVEF降低,3D-LVESV、3D-LVEDV升高(P<0.05)。受试者工作特征(ROC)曲线显示,除整体圆周应变(GCS)外,2D-STI、3D-HM参数均对CKD患者早期左心室收缩功能受损存在一定评估效力,各指标联合评估的曲线下面积(AUC)为0.945,灵敏度为85.86%,特异度为90.00%。结论2D-STI联合3D-HM可提升对CKD患者早期左心室收缩功能受损的评估效力。Objective To evaluate the value of two-dimensional speckle tracking imaging(2D-STI)combined with three-dimensional heart model(3D-HM)technique in assessing early left ventricular systolic function impairment in patients with chronic kidney disease(CKD).Methods A total of 99 CKD patients were selected as the CKD group,and 50 healthy volunteers were selected as the control group.Parameters from 2D-STI and 3D-HM examinations were collected from both groups and different CKD stage subgroups.The value of 2D-STI and 3D-HM parameters,both individually and in combination,in assessing early left ventricular impairment in CKD patients was analyzed.Results The CKD group had lower absolute value of global longitudinal strain(GLS),decreased three-dimensional left ventricular ejection fraction(3D-LVEF),but higher three-dimensional left ventricular end-systolic volume(3D-LVESV)and three-dimensional left ventricular end-diastolic volume(3D-LVEDV)compared with the healthy control group.With the increase of CKD stage,the absolute value of GLS and 3D-LVEF in CKD patients decreased,while 3D-LVESV and 3D-LVEDV increased(P<0.05).The receiver operating characteristic(ROC)curve showed that,except for global circumferential strain(GCS),both 2D-STI and 3D-HM parameters had certain evaluation capabilities for early left ventricular systolic impairment in CKD patients.The combined evaluation of these parameters for left ventricular systolic impairment yielded an area under the curve(AUC)of 0.945,with a sensitivity of 85.86%and a specificity of 90.00%.Conclusions The combination of 2D-STI and 3D-HM can enhance the evaluation efficacy of early left ventricular systolic impairment in CKD patients.

关 键 词：二维斑点追踪技术 三维超声全自动定量技术 慢性肾脏病 左心室功能 

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]