| 摘要: |
| 目的 应用二维斑点追踪应变成像技术(2DSTI)评估慢性肾病患者左心室功能,探究左心室整体纵向峰值应变与肾功能的相关性。方法 连续入选2016年8月-2019年5月于我院确诊为慢性肾功能不全患者共69名,其中36例2~3期慢性肾功能不全患者(轻度CKD组),33例4~5期慢性肾功能不全患者(中重度CKD组)以及30例年龄性别相匹配的健康志愿者(对照组)。收集所有患者临床基本资料,经胸超声心动图测量常规超声心动图指标,包括室间隔舒张末期厚度(IVSTd)、左心室舒张末期内径(LVIDd)、左心室心肌质量指数(LVMI)、左心室射血分数(LVEF)、左心房容量指数(LAVI)、E/e。应用2D-STI测量左心室整体纵向峰值应变(GLS)。应用多元线性回归分析超声各参数与肾小球滤过率(eGFR)之间的相关性。结果 与对照组相比,轻度CKD组IVSTd、LAVI、血肌酐增高,eGFR、GLS明显降低；与轻度CKD组相比,中重度CKD组收缩压、总胆固醇、血肌酐明显增高,IVSTd、LVMI、LAVI、E/e增大,eGFR、GLS减小(P<0.05)。eGFR与收缩压、血肌酐、IVSTd、LVMI、LAVI呈负相关,eGFR与GLS呈正相关(P<0.05),多元线性回归分析调整影响因素后,GLS与eGFR仍呈独立正相关。结论 随着病情发展,慢性肾功能不全患者左房扩大、左心室收缩功能减低,GLS与肾功能独立相关,2D-STI能敏感反映不同阶段慢性肾功能不全患者左心室功能改变。 |
| 关键词: 肾功能不全 心室功能 斑点追踪成像 左心房扩大 |
| DOI： |
| 投稿时间：2019-09-29修订日期：2019-10-21 |
| 基金项目: |
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| Study on the correlation between left ventricular global longitudinal strain and renal function in patients with chronic renal insufficiency |
| Chen Meicong,Jia Jie |
| () |
| Abstract: |
| Objective Two-dimensional speckle tracking strain imaging (2DSTI) was used to evaluate the left ventricular function in patients with chronic nephropathy and to explore the correlation between the global longitudinal peak strain of the left ventricle and renal function. Methods A total of 69 patients with chronic renal insufficiency diagnosed in our hospital from August 2016 to May 2019 were selected, including 36 patients with stage 2 and 3 chronic renal insufficiency (mild CKD group). 33 patients with stage 4 to 5 chronic renal insufficiency (moderate and severe CKD group) and 30 age and sex matched healthy volunteers (control group). The basic clinical data of all patients were collected, and the indexes of conventional echocardiography were measured by transthoracic echocardiography. It included interventricular septal end diastolic thickness (IVSTd), left ventricular end diastolic diameter (LVDd), left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), left atrial volume index (LAVI) and E/e". Left ventricle global longitudinal peak strain (GLS) of was measured by 2D-STI. Multiple linear regression was used to analyze the correlation between echocardiography parameters and glomerular filtration rate (eGFR). Results Compared with the control group, IVSTd and LAVI increased, eGFR and GLS decreased significantly in mild CKD group. Compared with mild CKD group, systolic blood pressure, total cholesterol, IVSTd, LVMI, LAVI, E "increased, eGFR and GLS decreased in moderate and severe CKD group. EGFR was negatively correlated with systolic blood pressure, IVSTd, LVMI and LAVI, while eGFR was positively correlated with GLS (P<0.05). After adjusting the influencing factors by multiple linear regression analysis, GLS and eGFR were still independently and positively correlated.Conclusion With the development of the disease, the left atrium enlarged and the left ventricular systolic function decreased in patients with chronic renal insufficiency. GLS is independently related to renal function. 2D-STI can sensitively reflect the changes of left ventricular function in patients with chronic renal insufficiency at different stages. |
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