三维斑点追踪技术评价青年尿毒症患者肾移植术后早期左室整体应变的价值

Assessment of early left ventricular global strain after kidney transplantation in young uremia patients by three-dimensional speckle-tracking imaging

目的探讨三维斑点追踪(3D-STI)技术评价青年尿毒症患者肾移植术后早期左室整体应变的临床价值。方法选取于我院成功行肾移植术的青年尿毒症患者31例(肾移植组)和与其年龄、性别相匹配的健康志愿者31例(正常对照组),正常对照组和肾移植组(术前、术后1个月、术后3个月)均行常规超声心动图和3D-STI检查,比较两组左室整体纵向应变(GLS)、左室整体圆周应变(GCS)、左室整体径向应变(GRS)、左室整体面积应变(GAS)的差异。采用组内相关系数(ICC)分析3D-STI参数在观察者内和观察者间的重复性。结果与正常对照组比较,肾移植组术前GLS、GCS、GRS、GAS均降低,术后3个月GLS、GAS均降低,差异均有统计学意义(均P<0.05);肾移植组术后3个月GCS、GRS与正常对照组比较差异均无统计学意义。肾移植组术后1个月GLS与术前比较差异无统计学意义,GCS、GRS、GAS均较术前降低,差异均有统计学意义(均P<0.05);术后3个月GLS、GCS、GRS、GAS均较术前升高,差异均有统计学意义(均P<0.05)。GLS、GCS、GRS、GAS在观察者内及观察者间的重复性良好(ICC观察者内=0.92、0.94、0.89、0.91,ICC观察者间=0.89、0.83、0.87、0.85)。结论3D-STI可评估青年尿毒症患者肾移植术后早期左室整体应变改变,具有重要的临床应用价值。

Objective To explore the clinical value of three-dimensional speckle-tracking imaging(3D-STI)in assessing the early left ventricular global strain after kidney transplantation in young uremia patients.Methods A total of 31 young uremic patients who successfully underwent renal transplantation(renal transplantation group)and 31 healthy volunteers with matched age and sex(normal control group)were selected.Routine echocardiography and 3D-STI parameter were measured in control group and renal transplantation group(pre-operation,1 month and 3 months after operation).The differences of left ventricular global longitudinal strain(GLS),left ventricular global radial strain(GRS),left ventricular circumferential strain(GCS)and left ventricular area strain(GAS)were compared.The repeatability of 3D-STI parameters of intra-and inter-observer were analyzed by intraclass correlation coefficient(ICC).Results Before operation,the GLS,GCS,GRS and GAS of the kidney transplantation group were lower than those of the normal control group,and the differences were statistically significant(all P<0.05).At 3 months after operation,there were no significant differences of GCS and GRS between the kidney transplantation group and the normal control group.There was no significant difference of GLS at 1 month after operation,but GCS,GRS and GAS were significantly decreased,and the differences were statistically significant(all P<0.05).Compared with pre-operation,GLS,GCS,GRS and GAS were significantly increased at 3 months after operation(all P<0.05).GLS,GCS,GRS,GAS between intra-and inter-had a good repeatability(ICC of intra-observer were 0.92,0.94,0.89,0.91,ICC of inter-observer were 0.89,0.83,0.87,0.85).Conclusion 3D-STI can evaluate the changes of left ventricular global strain in young uremia patients after kidney transplantation,which has important clinical application value.