血液透析患者心脏病变及超声检查在其诊断中的应用

Cardiovascular changes and the diagnosis using ultrasonography in patients with hemodialysis

维持性血液透析(MHD)患者死亡率高,心血管疾病死因约占50%,其中心源性猝死又占心血管死因的50%左右。超声心动图可有助于早期发现心脏结构、功能异常,以利于早期干预、改善预后,但其成像质量受操作者技术、经验和患者自身声窗条件影响很大,导致常规二维超声心动图参数的准确性和重复性差;MHD患者的血流动力学和容量状态受透析的影响,从而影响心脏超声检查准确性。新的超声成像技术,如三维超声、组织多普勒和斑点追踪技术等,能够提供更多检查参数和更准确的诊断信息,可帮助临床进一步了解MHD患者心脏结构、功能的病理生理变化。

The mortality of hemodialysis patients is high. Cardiovascular disease accounts for almost half of it, one of the most common cause is sudden cardiac death. Early detection of abnormalities in cardiac structure and function may be important. Echocardiography provides invaluable information on cardiac morphology and function. However, the limitation of it is that image quality can vary depending on the operator-s experience and the patient-s acoustic window. The hemodialysis patients undergo regular hemodynamic changes, that also may affect echocardiographic findings. An understanding of the prognostic significance and interpretation of echocardiographic results in this setting is important for patient care. There are some emerging techniques in echocardiographic imaging that can provide more detailed and accurate information compared with conventional 2-dimensional echocardiography. Use of these novel tools may further our understanding of the pathophysiology of cardiac disease in patients undergoing hemodialysis.