组织多普勒显像评价终末期肾病患者的心室功能

The Assessment of Ventriculars Function by Tissue Doppler Imaging in Patients with End-Stage Renal Disease

目的探讨组织多普勒显像参数评价终末期肾病患者心室功能的价值。方法健康成人和左心室射血分数正常的终末期肾病患者各31例,均行二维及组织多普勒显像检测,记录左心室射血分数、左心室舒张末期内径、左心室收缩末期内径、室间隔和左心室后壁厚度;二尖瓣和三尖瓣口舒张早期及舒张晚期峰速,计算二尖瓣和三尖瓣口舒张早期与舒张晚期峰速之比。组织多普勒显像下心尖四、两腔测定左心室后间隔、侧壁、前壁、下壁以及右心室侧壁的收缩期运动速度、舒张早期和舒张晚期运动速度,计算二尖瓣和三尖瓣口舒张早期峰速与舒张早期运动速度之比、舒张早期运动速度与舒张晚期运动速度之比。比较两组左、右心室超声参数。结果与健康成人相比,终末期肾病患者二尖瓣和三尖瓣口舒张早期峰速与舒张晚期峰速之比、二尖瓣和三尖瓣环平均收缩期运动速度、舒张早期运动速度、舒张早期运动速度与舒张晚期运动速度之比均减低;二尖瓣舒张早期峰速与舒张早期运动速度之比增高(P<0.05)。结论终末期肾病患者左、右心室存在舒张功能障碍,收缩功能亦受损;左心室射血分数正常的终末期肾病患者收缩功能亦受损。

Aim To explore the value of tissue doppler imaging in the evaluation of ventricular function in patients with end-stage renal disease. Methods 31 patients with end-stage renal disease of the normal eject factionand 31 healthy subjects were selected for routine 2D and tissue doppler imaging.Left ventricular eject faction,interventricular septum thickness,left ventricular posterior wall thickness,left ventricular internal dimensions and left ventricular internal dimensions were measured.Conventional left and right ventricular diastolic function parameters were acquired by pulsed doppler.Including to the mitral and tricuspid flow velocity,the ratio of the mitral and tricuspid early diastolic velocity and late diastolic velocity were calculated.The mitral and tricuspid annular early and late diastolic velocities were determined by tissue doppler imaging in apical views（4-and 2-chamber）,and the ratio of the mitral and tricuspid early diastolic velocity and the mitral and tricuspid annular early diastolic velocities,and the ratio of the mitral and tricuspid annular early diastolic velocities and late diastolic velocities were calculated.Then function parameters of the end-stage renal disease group were compared with healthy group,and the corrections between the parameters were analyzed. Results The end-stage renal disease patients had lower ratio of the mitral and tricuspid early diastolic velocity and late diastolic velocity,the mean mitrial and tricuspid systolic velocities,the mean mitral and tricuspid annular early and late diastolic velocities,the mean ratio of the mitral and tricuspid annular early diastolic velocities and late diastolic velocities were significantly reduced,while the ratio of the mitral and tricuspid early diastolic velocity and the mitral and tricuspid annular early diastolic velocities was significantly increased. Conclusion Patients with end-stage renal disease had left and right ventriculars diastolic dysfunction,and so were systolic function.Systolic was impaired in patients with end-stage renal disease with normal ejection fraction.