不同程度慢性肾脏病心脏超声表现及其与临床分期的相关性

Cardiac Ultrasound Manifestations of Different Degrees of Chronic Kidney Disease and Correlation with Clinical Staging

目的:分析探讨不同程度慢性肾脏病(CKD)患者心脏超声表现,以及CKD患者心脏超声指标与临床分期的相关性。方法:选取2021年1月—2023年7月新余北湖医院收治的81例CKD患者,根据患者CKD分期将其分为轻中度组(1~3期)47例与重度组(4期和5期)34例,所有患者均行心脏彩超检查。比较两组心脏结构指标[室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左房前后径(LAD)、左房最小容积指数(LAVImin)]、舒张功能指标[二尖瓣环血流舒张早期峰值速度(E)/组织多普勒二尖瓣环舒张早期峰值速度(e')、E/二尖瓣环血流舒张晚期峰值速度(A)、E峰减速时间(DT)]、收缩功能指标[左室质量指数(LVMI)、左室射血前期(PEP)、左室射血分数(LVEF)],采用Spearman分析心脏超声指标与CKD患者分期的相关性。结果:重度组患者IVST、LVPWT、LAD、LAVImin、E/e'、DT、LVMI、PEP均高于轻中度组,差异均有统计学意义(P<0.05);重度组E/A、LVEF均低于轻中度组,差异均有统计学意义(P<0.05);Spearman分析显示,IVST、LVPWT、LAD、LAVImin、E/e'、DT、LVMI、PEP均与CKD患者分期呈正相关,差异均有统计学意义(P<0.05);E/A、LVEF均与CKD患者分期呈负相关,差异均有统计学意义(P<0.05)。结论:不同程度CKD患者心脏超声表现差异明显,且CKD患者心脏超声指标与临床分期具有显著相关性。

Objective:To analyze and discuss the cardiac ultrasound manifestations of patients with different degrees of chronic kidney disease(CKD)and the correlation between cardiac ultrasound indicators and clinical staging of CKD patients.Method:A total of 81 patients with CKD in Xinyu Beihu Hospital from January 2021 to July 2023 were included and were divided into mild-to-moderate group(stage 1-3,47 cases)and severe group(stage 4 and 5,34 cases)by means of CKD staging.All patients received cardiac color Doppler ultrasound examination.The cardiac structure indexes[interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left atrial anteroposterior diameter(LAD),left atrial minimum volume index(LAVImin)],diastolic function indexes[early peak diastolic velocity of mitral annular blood flow(E)/early peak diastolic velocity of mitral annulus using Doppler echocardiography(e'),E/late diastolic peak velocity of mitral annular blood flow(A),E-peak deceleration time(DT)],systolic function indexes[left ventricular mass index(LVMI),left ventricular pre-ejection period(PEP),left ventricular ejection fraction(LVEF)]were compared between two groups.Spearman analysis was used to analyze the correlation between cardiac ultrasound indexes and staging of patients with CKD.Result:IVST,LVPWT,LAD,LAVImin,E/e',DT,LVMI and PEP in severe group were higher than those in mild-to-moderate group,with statistical differences(P<0.05),while E/A and LVEF in severe group were lower than those in mild-to-moderate group,with statistically significant differences(P<0.05).Spearman analysis showed that IVST,LVPWT,LAD,LAVImin,E/e',DT,LVMI and PEP were positively correlated with staging of CKD patients(P<0.05).E/A and LVEF were negatively correlated with staging of CKD patients(P<0.05).Conclusion:The cardiac ultrasound manifestations of patients with different degrees of CKD are significantly different,and the cardiac ultrasound indicators of CKD patients are significantly correlated with clinical staging.