| 摘要: |
| ［摘要］ 目的 应用彩色多普勒超声观察连续性肾脏替代治疗（Continuous Renal Replacement Therapy,CRRT）前后慢性肾功能衰竭患者右心室功能和容量的变化。方法 选择行连续性肾脏替代治疗的慢性肾功能衰竭患者71例，收集患者超声心动图参数，包括三尖瓣环收缩期纵向位移（TAPSE）、右室面积变化分数（FAC）、侧壁三尖瓣环收缩期峰速度（S’）、右室舒张末容积（RV EDV）、右室基底横径［RVDd（base）］。观察患者CRRT前后右心室参数的变化，探讨患者CRRT前TAPSE与CVP的相关性。结果 与CRRT前相比，CRRT后RV EDV和[RVDd（base）]降低，差异有统计学意义（P＜0.05）。CRRT前后S’之间无显著差异。CRRT前TAPSE为（15.37±4.45）mm，CRRT后TAPSE（16.89±5.01）mm增加，CRRT前FAC为（46.12±10.57）mm，CRRT后FAC（48.88±11.90）mm增加，差异有统计学意义（P＜0.05）。CRRT前TAPSE与CVP具有相关性（r=-0.592，P=0.000）。结论 TAPSE、FAC反映右心室收缩功能，CRRT可改善慢性肾功能衰竭患者右心室收缩功能。RV EDV、［RVDd（base）］反映右心室容积，提示CRRT可降低右心室容积。CVP随TAPSE的减低而增加，提示TAPSE可能成为反应容量的间接指标。 |
| 关键词: 右心室功能 超声心动图 慢性肾功能衰竭 连续性肾脏替代治疗 |
| DOI： |
| 投稿时间：2020-02-14修订日期：2020-02-25 |
| 基金项目: |
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| Ultrasound evaluation of right ventricular function changes before and after continuous renal replacement therapy |
| suqi,malin |
| (North China University of Science and Technology Affiliated Hospital) |
| Abstract: |
| [Summary] Purpose To observe the changes of right ventricular function and volume in patients with chronic renal failure before and after continuous renal replacement therapy (CRRT) using color Doppler ultrasound. Method Seventy-one patients with chronic renal failure who underwent continuous renal replacement therapy were selected. Echocardiographic examination of patients in the critical care department before and after continuous renal replacement therapy to collect the parameters of the right ventricle, including tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (FAC), tricuspid annular systolic peak speed (S’),right ventricular end diastolic volume (RVEDV), inner diameter of right ventricular basal segment [RVDd (base)].The changes of right ventricular function and volume parameters in patients with chronic renal failure before and after continuous renal replacement therapy were compared,and explore the correlation between TAPSE and CVP before continuous renal replacement therapy in patients with chronic renal failure. Result Compared with before continuous renal replacement therapy, RV EDV and [RVDd (base)] after continuous renal replacement therapy were lower than before treatment,the difference was statistically significant (P＜0.05).There was no significant difference between S 'before and after continuous renal replacement therapy.The TAPSE before continuous renal replacement therapy was (15.37±4.45) mm, the TAPSE after continuous renal replacement therapy increased by (16.89±5.01) mm,the difference was statistically significant (P＜0.05). The FAC before continuous renal replacement therapy was (46.12±10.57) mm, and the FAC after CRRT increased by (48.88±11.90) mm,the difference was statistically significant (P <0.05).Correlation between TAPSE and CVP before continuous renal replacement therapy in patients with chronic renal failure (r=-0.592, P=0.000). Conclusion TAPSE and FAC can roughly reflect right ventricular systolic function. After continuous renal replacement therapy, TAPSE and FAC increase in patients with chronic renal failure than before treatment, suggesting that continuous renal replacement therapy can improve chronic renal failure. The right ventricular systolic function of the patient RVEDV, [RVDd (base)] reflects right ventricular volume, suggesting that continuous renal replacement therapy can reduce right ventricular volume. CVP increases with the decrease of TAPSE, suggesting that TAPSE may become an indirect indicator of response capacity. |
| Key words: Right ventricular functions Echocardiogram Chronic renal failure Continuous renal replacement therapy |
