心肺联合超声在评估血液透析患者容量负荷中的应用价值  

The Value of Combined Cardiopulmonary Ultrasound in Assessing Volume Status in Hemodialysis Patients

作　　者：王敏[1] WANG Min(Cardiovascular Disease Center,Suzhou Municipal Hospital,Jiangsu 215002,China)

机构地区：[1]苏州市立医院心血管病中心,江苏215002

出　　处：《影像技术》2025年第2期39-44,共6页Image Technology

摘　　要：目的:评估心肺联合超声在维持性血液透析(maintenance hemodialysis,MHD)患者容量状态检测中的临床应用价值。方法:选取MHD治疗的患者47例,透析前后分别行心肺联合超声检查,比较透析前后超声心动图及肺超声参数及变化值。结果:透析后患者的体质量显著下降(P<0.05),左房内径、三尖瓣最大跨瓣压差等超声心动图参数及肺超声B线数量均有显著变化(P<0.05)。透析前后B线与心超参数发生变化,但均与左房内经、E/A、三尖瓣跨瓣压差这3个参数相关,三尖瓣跨瓣压差是透析前、后B线的独立预测因子。减少体质量与B线呈正相关(P<0.05),减少体质量是B线变化值的独立预测因子(P<0.05)。结论:心肺联合超声可以动态、有效地评估MHD患者容量状态,具有显著的临床应用价值。Objective:To investigate the clinical application value of combined echocardiogram and pulmonary ultrasound in detecting and evaluating volume status in patients undergoing maintenance hemodialysis(MHD).Methods:A total of 47 patients receiving MHD were selected,and both pre-dialysis and post-dialysis cardiopulmonary combined ultrasound examinations were conducted to compare the echocardiographic and lung ultrasound parameters as well as their changes.Results:The patients'body weight significantly decreased after dialysis(P<0.05).Parameters such as left atrial diameter,maximum gradient across the tricuspid valve,and the number of B-lines in lung ultrasound showed significant changes(P<0.05).Changes in B-lines and echocardiographic parameters occurred before and after dialysis and were correlated with left atrial diameter,E/A ratio,and tricuspid valve gradient;the tricuspid valve gradient was identified as an independent predictor of B-lines before and after dialysis.The reduction in body weight was positively correlated with B-lines(P<0.05),and the decrease in body weight was an independent predictor of the change in B-lines(P<0.05).Conclusion:Cardiopulmonary combined ultrasound can dynamically and effectively assess the volume status in patients undergoing MHD,demonstrating significant clinical application value.

关 键 词：超声心动图 肺超声 维持性血液透析 容量负荷状态 B线 慢性肾衰竭 

分 类 号：R445.1[医药卫生—影像医学与核医学]