组织多普勒超声联合Tei指数评价不同左室构型慢性肾脏病患者左心功能改变

Assessment of left ventricular function by tissue Doppler echocardiogra phy and Tei index in chronic kidney disease patients with different left ventric ular geometry

目的:利用组织多普勒超声联合Tei指数评价不同左室构型的慢性肾脏病(CKD4～5期)患者左心收缩、舒张功能改变。方法:对76例慢性肾脏病及20例志愿者进行常规超声心动图、组织多普勒超声和Tei指数评价左室收缩、舒张功能,慢性肾脏病患者根据不同左室构型分为:正常构型(n=23)、向心性重构(n=11)、离心性肥厚(n=12)及向心性肥厚(n=30)四组,比较各组之间改变。结果:慢性肾脏病患者ISVd、LVPWd及LVMI均高于对照组,Em/Am及E/Em和Tei指数较对照组均增高,Sm明显减低(P<0.05)。慢性肾脏病向心性肥厚组Em/Am和Tei指数明显高于其余三组。结论:慢性肾脏病患者左室收缩、舒张功能均减低,其中以左室向心性肥厚患者左心功能减低最明显,需引起临床特别注意。

Objective To assess the left ventricular systolic and diastolic function by tissue Doppler echocardiography and Tei index in chronic kidney disease patients with differen t left ventricular geometry.Method Conventional and tissue Doppler echocardiography were recorded in 76 p atients（CKD 4～5） and in 20 healthy controls.Patients were classified into fo u r groups by RWT and LVMI：23 patients with normal geometry;11 with concentric r emodeling;12 with eccentric hypertrophy;and 30 with concentric hypertrophy.Ec h ocardiography characters were compared between four groups with healthy controls.Results Chronic kidney d i sease patients showed a higher ISVd,LVPWd and LVMI than healthy controls.In ti s sue Doppler image,higher Em/Am,E/Em,Tei index were found in chronic kidney di sease patients,and the Sm was significantly lower than healthy controls（P 0.05）.Em/Am and Tei index were significantly greater in concentric hypertrophy t han other three groups.Conclusion Left ventricular systolic and diastolic dysfunction are detected in pat ients with chronic kidney disease.More attention should be paid to concentric h ypertrophy patients for worse left ventricular function.