| 摘要: |
| 目的：探讨峰值应变离散度（PSD）评价慢性肾脏病（CKD）患者左心室收缩同步性的临床应用价值。
方法：选取我院收治的CKD患者96例，根据肾小球过滤率（GFR）水平进行分组：GFR30~89ml/min者50例（A组）和GFR＜30 ml/min患者46例（B组），另选取同期健康成人50例为对照组。各组均行经胸二维超声心动图检查，测量常规超声心动图参数，然后采集连续3个心动周期的左室心尖四腔、三腔、两腔观二维动态图像，计算左室PSD和左室整体纵向应变（LVGLS），比较各组上述参数的差异，分析PSD与LVGLS的相关性，检验PSD值在观察者内部和观察者间的重复性。
结果：除左室射血分数(LVEF)及左室内径缩短率(LVFS)外，B组的常规超声心动图参数值均明显高于对照组和A组（均P＜0.05）；A组常规超声心动图参数与对照组比较，差异均无统计学意义。对照组、A组、B组PSD呈逐渐增大趋势，各组间两两比较差异均有统计学意义（均P＜0.05）；对照组、A组、B组LVGLS呈逐渐减小趋势，各组间两两比较差异均有统计学意义（均P＜0.05）。相关性分析显示，PSD与LVGLS呈负相关（r=-0.91，P＜0.01）。PSD测值在观察者内和观察者间均有很高的一致性。
结论：PSD可早期、定量评价CKD患者左室收缩同步性，可作为一种新的可靠评价指标。 |
| 关键词: 超声心动描记术 峰值应变离散度 #$NBS同步性 #$NBS慢性肾脏病 #$NBS左室功能 |
| DOI： |
| 投稿时间：2020-12-05修订日期：2021-12-12 |
| 基金项目:1、安徽省2017年公益性技术应用研究联动计划项目（1704f0804048）; 2、2020年芜湖市科技计划项目(2020ms3-5) |
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| Evaluation of left ventricular systolic synchrony in chronic kidney disease patients by peak strain dispersion |
| ji xiang,Zhang Xia |
| () |
| Abstract: |
| Objective: To investigate the clinical value of peak strain dispersion（PSD） in evaluating leftventricular systolic synchrony in patients with chronic kidney disease（CKD）.
Methods: 96 patients with CKD were divided into two groups according to the glomerular filtration rate（GFR） level.There were 50 cases in GFR 30-89ml/min group（group A），and 46 cases in GFR＜30 ml / min group（group B），and 50 healthy people were selected as the control group.All the three groups were examined by transthoracic two-dimensional echocardiography，measuring the parameters of conventional echocardiography，collecting the two-dimensional dynamic images of apical four chamber and three chamber views，and two chamberlong axis view of Left ventricular for three consecutive cardiac cycles.The left ventricular PSD and left ventricular global longitudinal strain（LVGLS） were calculated，parameters of cardiac configuration and functional among the three groups were compared，and the correlation between PSD and LVGLS was analyzed.
Results: Except for left ventricular ejection fraction (LVEF) and left ventricular diameter shortening rate (LVFS), the conventional parameter values were significantly higher in group B than in the control group and group A (all P＜0.05）. There were no significant differences in conventional echocardiographic parameters between group A and the control group. PSD gradually increased from control group to group A and then to group B，and the difference among the groups was statistically significant（all P＜0.05）.LVGLS gradually decreased from control group to group A and then to group B，and the difference among the groups was statistically significant（all P＜0.05）；PSD was negatively correlated with LVGLS.
Conclusion: PSD could early and quantitatively detect left ventricular systolicsynchrony in CKD patients，the systolic synchrony in CKD patients decreases gradually with the development of disease，PSD can be used as a new reliable index to evaluate left ventricular systolic synchrony. |
| Key words: Echocardiography Peak strain dispersion SSynchrony SChronic kidney disease Left ventricular function |
