斑点追踪技术对慢性肾脏病患者心脏功能的评估效果

Effects of speckle tracking imaging on cardiac function in patients with chronic kidney disease

目的探讨斑点追踪技术(STI)对慢性肾脏病(CKD)患者心脏功能的评估效果。方法选取2017年5月至2018年5月江门市中心医院收治的CKD患者134例,按照肾功能损害的程度分为五组,CKD1期组28例,CKD2期组24例,CKD3期组24例,CKD4期组28例,CKD5期组30例。另选取同期进行体检无心肺疾病的健康志愿者30例为正常对照组。应用常规心脏测量方法及斑点追踪技术对受试者心脏进行测量,并分析其测量值或图像结果。结果慢性肾脏病晚期(CKD4、CKD5)STI心脏各切面的峰值应变值及平均峰值应变值均较正常对照组减低(-15.25±4.45比-19.59±8.37;-15.92±3.80比-19.59±8.37)。心尖段的心尖部各心脏节段的峰值应变值随着CKD进展而减低(-26.87±4.65比-23.87±6.11比-22.90±4.31比-23.75±4.86比-17.34±6.56比-15.23±5.52)。牛眼图可直观反映早期峰值应变异常的节段。结论斑点追踪成像技术能显示慢性肾脏病患者的心脏峰值应变的特点,反映心肌运动情况,能发现更早期的心功能异常,可为左心室整体及不同节段心脏功能改变提供诊断依据。

Objective To investigate the effects of speckle tracking imaging (STI) on cardiac function in patients with chronic kidney disease (CKD). Methods A total of 134 patients with CKD and 30 healthy volunteers in Jiangmen Central Hospital from May 2017 to May 2018 were selected and divided into 5 groups according to the degree of renal dysfunction, including CKD 1 group (n=28), CKD2 group (n=24), CKD3 group (n=24), CKD4 group (n=28), CKD5 group (n=30). Another 30 healthy volunteers who had no cardiopulmonary were selected as the normal control group. The heart of each group of subjects was measured using conventional cardiac measurement methods and speckle tracking techniques, and the measured values or image results were analyzed. Results The various facets peak strain value and the average peak strain value of the heart in the late stage of chronic kidney disease (CKD4, CKD5) were lower than those in the normal control group(-15.25±4.45 vs.-19.59±8.37;-15.92±3.8 vs.-19.59±8.37). The peak strain value of each cardiac segment of the apex of the apex segment decreased as CKD progressing(-26.87±4.65 vs.-23.87±6.11 vs.-22.9±4.31 vs.-23.75±4.86 vs.-17.34±6.56 vs.-15.23±5.52). Bull’s eye diagram could visually indicate segments with abnormal peak strain. Conclusions Speckle tracking imaging can show the characteristics of cardiac peak strain in patients with chronic kidney disease, reflect myocardial motion, and can find early cardiac dysfunction, which can provide a diagnostic basis for cardiac function changes in the left ventricle and different segments.