应用速度向量成像评价尿毒症患者左心功能

Evaluation of left ventricular function with velocity vector imaging in uremic patients

目的应用速度向量成像（VVI）评价不同甲状旁腺素（PTH）水平尿毒症患者的左心功能。方法60例尿毒症患者，按血清PTH值分为PTH％正常值上限3倍组（A组）和PTH〉正常值上限3倍组（B组）。30例健康者作为对照组。VVI定量测定受试者左心长轴16个节段的收缩期应变率（SSR）、舒张期应变率（DSR），并进行三组间比较。结果与对照组相比，A、B组心肌各节段SSR、DSR均减低。与A组相比，B组各节段DSR均减低，差异有统计学意义（P〈0．05）；B组SSR均减低，其中左室侧壁心尖段、后间隔及下壁中间段、心尖段，前壁基底段、中间段、心尖段，前间壁、后壁中间段的差异有统计学意义（P〈0．05）。两组间左室射血分数差异无统计学意义（P〉0．05）。结论VVI技术可早期、敏感地反映不同PTH水平的尿毒症患者左心局部心肌功能的差异。

Objective To assess the left ventricular （LV） segmental function by velocity vector imaging（VVI） in uremic patients with diffierent quantity of parathyroid hormone（PTH）. Methods Sixty patients with uremia were divided into 2 groups according to the value of PTH：group A with PTH less than 3 times of upper normal limit,group B with PTH more than 3 times of upper normal limit. Normal control group was 30 healthy subjects. All people were evaluated by VVI. The parameters,including the longitudinal systolic strain rate（SSR）, diastolic strain rate（DSR）, were analysed among the three groups. Results Compared with normal group, in group A and B, SSR,DSR in all segments were lower. Compared with group A,in group B,DSR were all significantly lower（ P 〈0.05） ,SSR in apex of laternal wall,medium of anterior septum wall,posterior wall,medium and apex of posterior septum wall and superior wall, base, medium and apex of anterior wall were significantly lower（ P〈0.05）. There was no statistically significant difference of left ventricular ejection fraction between the two groups（ P〉0.05）. Conclusions VVI is a viable objective tool to quantitatively assess LV segmental {unction damaged by different quantity of PTH.