应变率成像及三维超声评估尿毒症患者左心房收缩功能

Evaluation of left atrial systolic function in uremia patients with strain rate imaging and real-time three-dimensional echocardiography

目的探讨应变率成像(SRI)和三维超声评价尿毒症患者左心房收缩功能的临床价值。方法应用二维、三维超声心动图和SRI分别测量44例尿毒症患者(男23例,女21例)和40名正常人(男20名,女20名)左心室后壁厚度(LVPWT)、室间隔厚度(IVST)和左心室舒张末期内径(LVID)、左心房各壁上段心房收缩期应变率峰值(SRa)、三维左心房最大容积(LAVmax)、左心房最小容积(LAVmin)和左心房收缩前容积(LAVp)。计算左心室重量指数(LVMI)、左心房射血分数(LAEF)及左心房主动收缩排空容积(LASV)。结果相同性别的两组间LVMI均在正常值范围内,差异无统计学意义;相同性别的两组间左心房壁SRa、LAEF及LASV的差异有统计学意义(P<0.05)。结论SRI及三维超声能在左心室结构无明显改变的情况下,能够早期发现尿毒症患者左心房收缩功能的改变。

Objective To evaluate left atrial （LA） systolic function in uremia patients with strain rate imaging （SRI） and real-time three-dimensional echocardiography. Methods Forty-four patients （male： 23, female： 21） with uremia and 40 healthy volunteers （male： 20, female： 20） were involved. Left ventricle posterior wall thickness （LVPWT）, interventricular septal thickness （IVST） and left ventricle internal diameter （LVID）, the left atrial strain rate （SRa） at each left atrial top segment of each walls, the maximun left atrial volume （LAVmax）, minimum left atrial volume （LAVmin） and left atrial volume before systole （LAVp） were recorded. Mass left ventricular mass index （LVMI）, left atrial ejection fraction （LAEF） and left atrial systolic volume （LASV） were calculated. Results There was no statistical difference of LVMI at the normal value range between patients with uremia and healthy volunteers （same gender）. Statistical differences in left atrial SRa, LASV and LAEF were found between patients with uremia and healthy volunteers （same gender, P〈0. 05）. Conclusion Left atrial systolic function changes in patients with uremia without obvious changes in left ventricle can be early detected with SRI and real-time three-dimensional echocardiography.