双多普勒同步取样技术测量Tei指数联合脑钠肽评价慢性肾病左心功能的研究

Tei index detected by dual Doppler simultaneous sampling technique combined with brain natriuretic peptide for measuring left ventricular function in chronic kidney disease

目的探讨双多普勒同样取样技术测量Tei指数联合脑钠肽(BNP)评价慢性肾病左心功能的应用价值。方法选取我院2017年1～12月收治的80例慢性肾病患者(观察组)及40例健康体检的正常人(对照组)为研究对象,其中观察组分为早期肾功能不全组(早期组)、中晚期肾功能不全组(中晚期组)。比较观察组与对照组的常规超声检测指标、TDI检测指标,分析Tei指数与左室射血分数(LVEF)以及NT-proBNP的相关性。结果中晚期组的LVIDd、LVIDs、LA、IVSd、LVPWd均大于对照组,差异有统计学意义(P<0.05)。中晚期组的E、A、Tei指数、NTproBNP大于对照组,E/A、LVEF小于对照组,早期组E/A、LVEF小于对照组,Tei指数、NT-proBNP大于对照组,差异有统计学意义(P<0.05)。相关性分析显示,Tei指数与NT-proBNP呈正相关(P<0.05),与LVEF呈负相关(P<0.05)。结论慢性肾病患者合并有一定的心功能损害,Tei指数与NT-proBNP可早期预测心功能损害的严重程度。

Objective To investigate the application value of Tei index detected by dual Doppler simultaneous sampling technique combined with brain natriuretic peptide in measuring left ventricular function in chronic kidney disease. Methods 80 patients with chronic kidney disease (observation group) and 40 healthy controls (control group) admitted in our hospital from January to December 2017 were selected as subjects. The observation group was divided into early renal dysfunction group(early group), mid- and end-stage renal dysfunction group(mid-and end-stage group). The conventional ultrasound detection index and TDI detection index of the observation group and the control group were compared, and the correlation between Tei index and left ventricular ejection fraction(LVEF) and NT-proBNP was analyzed. Results The LVIDd, LVIDs, LA, IVSd and LVPWd in the mid-and end-stage group were significantly higher than those of the control group, and the difference was statistically significant(P<0.05). The E, A, Tei indexes and NT-proBNP of the mid-and end-stage group were higher than those of the control group, E/A and LVEF of the mid-and end-stage group were lower than those of the control group. The E/A and LVEF of the early group were smaller than those of the control group, and the Tei index and NT-proBNP of the early group was larger than that of the control group. The difference was statistically significant (P<0.05). Correlation analysis showed that the Tei index was positively correlated with NT-proBNP (P<0.05) and negatively correlated with LVEF(P<0.05). Conclusion Patients with chronic kidney disease have a certain degree of cardiac dysfunction. Tei index and NT-proBNP can predict the severity of cardiac dysfunction early.