2D—STI评价腹膜透析患者的左室收缩功能

目的探讨采用超声二维斑点追踪成像技术（2D-STI）定量评价腹膜透析患者的左心室（左室）收缩功能。方法尿毒症患者48例，分为腹膜透析组30例及未透析组18例；另选取30例健康者为对照组。分别测量左室各节段收缩期纵向、径向及环向峰值应变；并计算左室各水平段整体纵向、径向及环向应变的峰值。结果尿毒症患者在各节段和各水平的纵向应变峰值均较对照组显著下降（P〈0．05），腹透组和未透组在各节段和各水平的纵向应变峰值未见明显差异；未透组在各节段和各水平径向应变较对照组和腹透组显著下降（P〈0．05），腹透组仅在基底段的前、后间隔径向应变峰值较对照组下降（P〈0．05），但其各水平段总体径向应变峰值较对照组无明显差异：三组环向应变在各节段和各水平无明显差异。结论尿毒症患者存在整体纵向、径向收缩功能下降，未透析患者的径向收缩功能较腹透患者进一步下降，提示腹透可改善尿毒症患者径向收缩功能。

Objective To assess the left ventricular （ LV ） function with two-dimensional speckle tracking image （ 2D-STI ） in peritoneal dialysis patients. Methods This study included 30 maintenance peritoneal dialysis patients （ PD group ） , 18 uremia patients waiting for dialysis therapy （ pre-D group ） , and 30 healthy volunteers （ control group ） . Segmental LV peak systolic strain （ PSS ） was measured. Global systolic strain （ GSS ） was calculated by the average of PSS in each level. Results Longitudinal Strain of PSS and GSS in both PD group and pre-D group were significantly lower than those in control group （ P〈0.05 ） , but there is no significant difference between the PD and pre-D group. Radial strain of PSS and GSS in pre-D group were significantly lower than those in the other two groups （ P〈0.05 ） . Radial strain of GSS in PD group was similar to those in control group, PSS of anterior and posterior septum in basal level of PD group were lower than the corresponding segments of control group （ P〈0.05 ） . There were not obviously different of PSS and GSS in circumferential direction among the three groups. （ P〉0.05 ） . Conclusion The LV fimction is low in uremia patients in the longitudinal and radial direction, and nondialysis patients have a bad Radial Strain than those PD patients, which indicates peritoneal dialysis may improve the function of uremia patients in radial direction.