二维斑点追踪显像和实时三维超声心动图评价慢性肾脏疾病患者左室功能的研究

Evaluation of Left Ventricular Function in Patients with Chronic Kidney Disease by Two-dimensionalspeckle tracking Imaging and Real-time Three-dimensional Echocardiography

目的:应用二维斑点追踪显像和实时三维超声心动图评价慢性肾脏病(CKD)患者左室功能。方法:应用二维斑点追踪显像技术,获取40例CKD患者(CKD组)和39例健康体检者(对照组)的左室整体纵向应变(GLS)及应变率(GLSR),左室整体周向应变(GCS)及应变率(GCSR);同时实时三维超声心动图技术测得左室舒张末期容积(LVEDV),左室收缩末期容积(LVESV),三维左室射血分数(LVEF 3DE),所得容积参数用体表面积进行校正,获得相应容积指数(LVEDVi, LVESVi)。据容积-时间曲线计算左室16节段达到最小收缩容积时间的标准差(Tmsv16-SD)及最大时间差(Tmsv16-Dif),结果以R-R间期标准化Tmsv16-SD(%R-R),Tmsv16-Dif(%R-R)。比较两组上述各指标变化情况。结果:与对照组比较,CKD组应变和应变率均明显降低,LVEDVi、LVESVi、Tmsv16-SD(%R-R)及Tmsv16-Dif(%R-R)均明显增高,而LVEF 3DE则明显减小,差异均有统计学意义(均P<0.05)。结论:CKD患者左室功能减退,二维斑点追踪显像和实时三维超声心动图可用于评价CKD患者左室功能变化。

Objective:To evaluate the left ventricular funtion in patients with chronic kidney disease by two dimensional-speckle tracking imaging(2 D-STI) and real-time three-dimensional echocardiography(RT-3 DE).Methods:Forty patients with chronic kidney disease(CKD group) and thirty-nine healthy individuals(CTL group) were enrolled in this study.The strain and strain rate(GLS, GLSR, GCS, GCSR) were measured by 2 D-STI. The left ventricular end-diastolic volume(LVEDV), left ventricular end-systolic volume(LVESV), LVEF 3 DE were acquired by RT-3 DE, and all volume parameters were corrected by the body surface area. Standard deviation and the maximum difference ofthe time to the point with minimal systolic volume in 16 segment of left ventricular(Tmsv16-SD, Tmsv16-Dif)were corrected by R-R interval(Tmsv16-SD(%R-R),Tmsv16-Dif(%R-R)).Results:Compared with the CTL group, the strain and strain rate were significant reduced in CKD group(all P<0.05). All the volume index, Tmsv16-SD(%R-R),and Tmsv16-Dif(%R-R) of the CKD group were obviously higher than those of the CTL group, but LVEF 3 DE was just the reverse(all P<0.05).Conclusion:The left ventricular funtion reduced in patients with CKD. 2 D-STI and RT-3 DE may effectively evaluate the changes of left ventricular funtion.