应变及应变率显像评价尿毒症性心肌病的心功能

Left ventricular function assessment with strain and strain rate imaging in uremic myocardiopathy

目的探讨应变及应变率显像评价尿毒症性心肌病(尿毒症组)心功能的价值。方法应用应变、应变率显像、组织多普勒显像测量35例尿毒症性心肌病与30例正常人(对照组)左室各节段的应变(ε,包括εS和εE)、应变率(SR,包括SRS和SRE),室壁运动峰值流速(V,包括VS和VE)。结果尿毒症组的εS、SRS、SRE、VS、VE明显低于对照组(t分别=2.45、2.09、5.31、4.26、4.63,P均<0.05);②εS、SRS、SRE和VS、VE呈直线正相关(t分别=4.78、5.63、5.05和4.31、4.91、5.05,P均<0.05);③εS、SRS、SRE评价心功能受损的敏性和特异性均高于参数VS(t分别=2.05、2.14、2.74和2.17、2.07、2.69,P均<0.05),SRS、SRE评价心功能受损的敏感性和特异性也均高于参数VE(t分别=2.08、2.15和2.11、2.07,P均<0.05)。结论应变、应变率显像能较好地评价心肌局部收缩功能,对早期诊断尿毒症心肌病有较好价值,为临床综合治疗提供理论依据。

Objective To evaluate the application of strain and strain rate imaging in assessing the left ventricular function in uremic myocardiopathy （UM）. Methods Thirty - five patients with UM and thirty normal control subjects were enrolled in the study. The strain （εS and εE ） , strain rate （SRS and SRE ）and peak velocity （VS and VE）of left ventricular walls were recorded , Results ① The εS, SRS, SRE, VS and VE in UM group were significantly lower than those in control group （ t = 2.45,2.09,5.31,4.26,4.63, P 〈 0.05）. ②εS, SRS and SRE were positive proportional to VS and VE （ t = 4.78, 5.63, 5.05, and 4.31,4.91,5.05, P 〈 0.05）. ③The sensitivity （SE） and specificity（SP） of εS, SRS and SItE for evaluating left partial ventricular were higher than VS （ t = 2.05, 2.14, 2.74 and 2.17, 2.07, 2.69, P 〈 0.05）, The SE and SP of SRS and SRE for evaluating left partial ventricular were higher than VE （ t = 2.08, 2.15 and 2.11, 2.07, P 〈 0.05） . Conclusions The strain and strain rate imaging were well in assessing partial ventricular function, and provide reliable parameters for clinical therapy.