维持性血液透析患者左心房容积指数的动态变化与左心室舒张功能的关系

Relationship between the dynamic change of left atrial volume index and left ventricular diastolic function in maintenance hemodialysis patients

目的探讨维持性血液透析患者左心房容积指数动态变化早期评价左心室舒张功能的价值。方法 137例维持性血液透析患者按照超声检测的二尖瓣E/A比值分为四组:正常组、相对正常组、早期减低组、降低组。利用左心房追踪技术(LAT)测量和计算四组患者左心房整体排出量(LAVIt)、被动排出量(LAVIp)、主动排出量(LAVIa),左心房总排空分数(LAVt EF)、左心房被动排空分数(LAVIpEF)、左心房主动排空分数(LAVIaEF)。多组间的比较根据是否满足方差齐性采用ANOVA或Welch分析,采用Bonferroni法行组间两两比较,P<0.05为差异有统计学意义。结果从正常组依次到相对正常组、早期降低组、降低组,LAVIp逐渐减低,降低幅度逐渐降低(P<0.05),早期降低组与正常组之间开始有显著差异(P<0.05);LAVIa逐渐增加,增加幅度逐渐降低(P<0.05),相对正常组与正常组之间已经有显著差异(P<0.05);LAVIt EF逐渐减低,降低幅度逐渐增加(P<0.05),早期降低组与正常组之间开始有显著差异(P<0.05);LAVIp EF逐渐增加,相对正常组与正常组之间已经有显著差异(P<0.05)。结论左心房容积的动态变化可以评估左心室舒张功能,LAVIa及LAVIp EF能够早于二尖瓣E/A比值判定左心室舒张功能降低。

ObjectiveTo investigate the value of early evaluating left ventricular diastolic function with dynamic changes of left atrial volume index in maintenance hemodialysis patients. Methods According to the mitral E/A ratio detected by ultrasonic, a total of 137 maintenance hemodialysis patients were divided into normal group, the relatively normal group, the early reduced group, the reduce group. Left atrial tracking technology (LAT) was utilized to measure and calculate LA total emptying volume (LAVIt), LA passive emptying volume (LAVIp), LA active emptying volume (LAVIa), LA total emptying fraction (LAVtEF), LA passive emptying fraction (LAVpEF), LA active emptying fraction (LAVaEF). To analyze the comparison between multiple groups depending on whether satisfy homogeneity of variance using ANOVA or Welch, to make the comparison between two groups using Bonferroni method, the difference had statistical significance,P<0.05.Results From the normal group to the relatively normal group, the early reduced group, the reduce group, LAVIp decreased gradually and the decreasing amplitude was gradually decreased (P<0.05), and began to have a significant difference between the normal group and the early reduced group (P<0.05). LAVIa increased gradually and the rate of increase gradually decreased (P<0.05), and had significant differences between the normal group and the relatively normal group (P<0.05). LAVItEF decreased gradually and the decreasing amplitude was&nbsp;gradually increasing (P<0.05), and began to have a significant difference between the normal group and the early reduced group (P<0.05). LAVIpEF increased gradually and had significant differences between the normal group and the relatively normal group (P<0.05).Conclusion Dynamic changes of left atrial volume can assess left ventricular diastolic function. LAVIpEF, LAVIa can earlier determine the reduce of left ventricular diastolic function than E/A ratio of mitral.