超声二维斑点追踪技术定量评价尿毒症患者心肌功能

Quantitative evaluation of myocardial function in patients with uremia by two-dimensional speckle tracking echocardiography

目的:探讨应用超声二维斑点追踪技术(STI)定量评价尿毒症患者心肌功能的价値。方法:尿毒症组(n=45)和健康对照组(n=38)分别行超声心动图,据左室射血分数(LVEF)将尿毒症组分为心功能正常组(n=29,LVEF≥50%)和心功能减退组(n=16,LVEF<50%),应用STI技术测量左室心肌各节段收缩期峰值应变,并计算出心肌整体纵向应变(LS)、径向应变(RS)及圆周应变(CS)。结果:与健康对照组相比,心功能正常组及心功能减退组室间隔、左室后壁明显增厚,左房内径增大(P<0.01);心肌应变比较,心功能正常组与健康对照组相比,心肌整体LS、CS均明显减低(P<0.01),心功能减退组较心功能正常组应变进一步降低(P<0.05)。结论:超声二维纵向、径向及圆周应变能够早期准确评价尿毒症患者心肌功能,其中纵向、径向应变较LVEF更早的发现心肌功能的减低。

Objective： To evaluate the accuracy and value of the two-dimensional speckle tracking imaging Eehocardiography （STI） quantitative measurement of global systolic function in cardiac patients with uremia. Methods： Routine parameters were determined by echocardiography in 45 uremic patients and 38 healthy controls. According to the left ejection fraction （LVEF）, the uremic group was divided into normal cardiac uremia group （n： 29, LVEF ≥50%） and cardiac dys- function group （n= 16, LVEF 〈50%）. We measured left ventricular myocardial sections of peak systolic strain by STI, and calculated the cardiac global longitudinal strain, radial strain and circumferential strain. Results： Compared with healthy control group, ventricular wail thickness, left atrium diameter were significantly different in Normal cardiac group and cardiac dysfunction group; Compared with healthy control group, the global longitudinal myocardial strain, circumferential strain were significantly lower （ P 〈0.01） cardiac dysfunction group compared with normal cardiac function, longitudinal, radial and circumferential strain were significant lower （ P 〈0.05）. Conclusion：The two-dimensional ultrasound speckle tracking imaging is earlier than left ventricular ejection fraction that decreases cardiac contractility in patients with uremia.