二维斑点追踪技术在同年龄段尿毒症患者左房功能中的研究

Application of two-dimensional speckle tracking echocardiography in left atrial function of uremic patients of the same age

目的应用超声心动图评价尿毒症患者左房大小及功能,并探讨年龄对其影响。方法选取金山医院肾内科2016年1月—2018年6月期间常规透析治疗尿毒症患者174例及性别、年龄相匹配的正常人55例为研究对象,按年龄<45岁、45~64岁及≥65岁分成青年组、中年组和老年组。超声心动图测量左房内径、容积及左房射血分数(LAEF);二维斑点追踪技术(2D-STE)测量左室收缩期、舒张早、晚期左房应变及应变率评估左房储备、管道及辅助泵功能。结果与同龄段对照组相比,尿毒症组左房内径、容积增大(老年组>中年组>青年组),左房应变及应变率降低(老年组<中年组<青年组);LAEF虽随年龄增加而降低,但与同龄段对照组相比,差异无统计学意义;尿毒症组年龄与左房大小、舒张中、晚期应变率呈正相关,与LAEF、收缩期应变、应变率及舒张早期应变呈负相关。结论尿毒症患者普遍存在左房扩大,左房储备、管道及辅助泵功能降低,并随年龄增加进一步加重;2D-STE优于传统容积功能测量,能有效评价尿毒症患者的左房功能。

Objective To evaluate the volume and function of left atrium(LA)in uremic patients by echocardiography,and to explore the influence of age on it.Methods 174 patients with uremia(uremia group)treated by routine dialysis in Department of Nephrology,Jinshan Hospital from January 2016 to June 2018,and 55 normal people(control group)matching gender and age were selected as the research subjects.They were further divided into youth group(<45 years),middle-aged group(45-64 years)and elderly group(≥65 years)according to age.LA diameter,volume and LA ejection fraction(LAEF)were measured by echocardiography;LA reserve,conduit and auxiliary pump function were measured by two dimensional speckle tracking echocardiography(2D-STE).Results Compared with the control group,the LA diameter and volume of uremia group increased(elderly group>middle-aged group>young group),and the LA strain and strain rate decreased significantly(elderly group<middle-aged group<young group).Although LAEF decreases with age,there was no statistically significant difference compared with the control group of the same age.In uremia group,age was positively correlated with LA size,middle and late diastolic strain rate,and negatively correlated with LAEF,systolic strain,strain rate and early diastolic strain.Conclusion LA enlargement is common in uremic patients,and the LA reserve,conduit and auxiliary pump function are significantly reduced,which will be further aggravated with the increase of age.