| 摘要: |
| 目的 应用二维斑点追踪显像技术(2D-STI)和实时三维超声心动图(RT-3DE)分别从心肌应变和容积变化的角度对尿毒症患者左心房功能进行定量评估,旨在探讨该群患者不同左房容积状态下左心房功能状况,为临床早期诊疗提供依据。方法 研究对象为69例尿毒症患者(尿毒症组)和22例正常人(对照组),RT-3DE时间-容积曲线获取左心房容积指标：最大容积(LAVmax)、最小容积(LAVmin)、收缩前容积(LAVp),计算左心房总射血分数(LAEF)、被动射血分数(LAPEF)、主动射血分数(LAAEF),容积指标LAVI由体表面积标化LAVmax得到。其中尿毒症组根据LAVI大小分为LAVI增高组(ELA组,LAVI＞34ml/m2)和 LAVI正常组(NLA组,LAVI≤34ml/m2 )。再应用2D-STI对上述受检者进行心肌应变及应变率曲线分析,获取参数包括：左心房壁平均应变(Sg、Se和Sa)及应变率(SRs、SRe和SRa)。结果①左心房壁平均Sg、SRs在对照组、NLA组、ELA组三组之间依次减低；与对照组相比较,NLA组、ELA组左心房壁平均Se、SRe均显著减低(P均＜0.05)；NLA组Sa高于对照组,ELA组低于对照组(P均＜0.05)②NLA组LAEF、LAAEF高于对照组,ELA组低于对照组(P均＜0.05)；LAPEF在对照组、NLA组、ELA组三组之间依次减低(P均＜0.05)；③LAPEF与SRe具有较强的相关性(r=0.529,P=0.000)；LAEF与Sa、SRa呈较好的正相关(r分别为0.501、0.498,P均=0.000)。结论 尿毒症患者左心房功能改变早于左心房构型改变,应用2D-STI联合RT-3DE技术可简便、快捷、准确评价其左心房功能,为临床早期诊疗提供依据。 |
| 关键词: 超声心动描记术，实时三维 尿毒症 心房功能，左 斑点追踪显像 |
| DOI： |
| 投稿时间：2017-07-28修订日期：2017-07-28 |
| 基金项目:湖北省卫计委青年人才项目(WJ2015Q016) |
|
| Evaluation of left atrial function in uremic patients by two-dimensional speckle tracking imaging and real-time three-dimensional echocardiography |
| mayuanyuan,guoruiqiang |
| (Renmin Hospital of Wuhan University) |
| Abstract: |
| Objective To evaluate the function of left atrium quantitatively in uremic patients by using two-dimensional speckle tracking imaging (2D-STI) and real-time three-dimensional echocardiography (RT-3DE) from the perspective of myocardiol strain and volume change respectively. To analyze the left atrial function in different left atrial volume level, in order to provide the basis for early clinical diagnosis and treatment. Methods Sixty-nine patients with uremia and twenty-two healthy volunteers as control group were studied. From the time-volume curve of RT-3DE workstation, the maximum volume (LAVmax), the minimum volume (LAVmin), the volume before contraction (LAVp) of left atrium were acquired. Accordingly, the total, passive and active ejection fraction of left atrium could be calculated.LAVmax was corrected by body surface area to obtainLAVI. The uremic patients were divided into two groups: enlarged LAVI group (LAVI＞34ml/m2, ELA group) and normal LAVIgroup (LAVI≤34ml/m2, NLA group). The mean left atrial strain and strain rate (Sg, Se, Sa, SRs, SRe and SRa) were measured by 2D-STI. The correlation of left atrial strain, strain rate, LAVImax and ejection fraction were analysed. Results ①The mean Sg and SRs of left atrial wall gradually decreased among the control, NLA and ELA group.Irrespective of the presence or absence of left atrial enlargement, the mean Se and SRe of uremic patients decreased significantly when compared with the control group (P＜0.05). Moreover, the mean Sa of the control group was higher than ELA group but lower than NLA group (P＜0.05).②LAEF and LAAEF of the control group were higher than ELA group but lower than NLA group (P＜0.05). LAPEF reduced gradually among the control, NLA and ELA group (P＜0.05).③LAPEF had a positive correlation with SRe (r=0.529, P=0.000), and LAEF had a significant correlation with Sa and SRa (r were 0.501 and 0.498 respectively, P both were 0.000).Conclusions Left atrial function changes earlier than its configuration. 2D-STI combined with RT-3DE can be used to evaluate left atrial function in uremic patients accurately and conveniently and provide the basis for early clinical diagnosis and treatment. |
| Key words: Echocardiography,real-time three-dimensional Uremia Atrial function,left Speckle tracking imaging |
