组织多普勒Tei指数评价不同透析时长尿毒症患者左心室功能的研究

Evaluation of left ventricular function in patients with uremia in different dialysis time by tissue Doppler echocardiography and Tei index

目的应用组织多普勒超声技术测量Tei指数评价不同透析时长尿毒症患者的左心室整体功能。方法对30例维持性血液透析尿毒症患者及30例健康志愿者分别进行常规超声心动图、组织多普勒技术条件下测量Tei指数评价其左心室整体功能。尿毒症患者根据不同透析时长分为A、B、C 3个实验组:A组透析时间<1年(n=10)、B组1年≤透析时间≤3年(n=10)、C组透析时间>3年(n=10),比较各组间的心室功能改变情况。结果实验组各组LVEDd及Tei指数均高于正常对照组,实验组ET均小于正常对照组(P<0.05),实验组中A组、B组LVEF值与正常对照组之间无显著性差异(P>0.05),C组与正常对照组之间差异有统计学意义(P<0.05),实验组中B组A值及E/A值较对照组差异有统计学意义(P<0.05),余实验组与对照组相比,E、A值及E/A值差异无统计学意义(P>0.05)。结论维持性透析尿毒症患者左室壁增厚,左室容积增加,左心室功能呈减低趋势。在常规超声心动图测得左心室收缩功能正常的尿毒症透析患者可能已经出现左心室舒张功能减低,通过组织多普勒测得的Tei指数可以很好地评价尿毒症透析患者的左心室整体功能,为临床及早干预提供更多依据。

Objective To evaluate the global left ventricular function in patients with different dialysis duration uremia by measuring Tei index by tissue Doppler ultrasonography. Methods 30 patients with maintenance hemodialysis and 30 healthy volunteers were treated with conventional echocardiography. Tissue Doppler technique was used to measure the Tei index to evaluate the left ventricular function.Uremia patients were divided into group A,group B and group C according to different dialysis duration ：Dialysis time 1 year in group A（n=10）,1 year ≤ dialysis time ≤3 years in group B（n=10）, dialysis time 3 years in group C（n=10）,compared the functional changes among the groups. Results The levels of LVEDd and Tei were higher in the experimental group than the normal control group.ET in the experimental group was lower than the normal control group（P〈0.05）.There was no significant difference in LVEF between group A,group B and normal control group（P〈0.05）,there was significant difference between group C and normal control group（P〈0.05）.The value of A and E/A in group B was significantly different from that in control group（P〈0.05）.There was no significant difference in E,A and E/A between the other cases and the control group（P〈0.05）. Conclusion The left ventricular wall is thicker, and the left ventricular volume is lower in patients with maintenance hemodialysis uremia. Left ventricular diastolic function may reduct in patients with normal left ventricular systolic function measured by the conventional echocardiography. Tei index measured by tissue Doppler can well evaluate left ventricular total function of uremic dialysis patients, provide more basis for clinical early intervention.