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三维斑点追踪成像技术评价肾移植前尿毒症患者的左心室收缩功能 |
祁英香,姜志荣,陈晓菲 |
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(青岛大学附属医院心脏超声科 山东 青岛 266000) |
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摘要: |
目的:应用三维斑点追踪成像技术(Three dimensional speckle tracking imaging technology,3D-STI)对肾移植前不同心室构型的尿毒症患者的左心室整体收缩功能进行评价,探讨其临床意义。方法:选择85例拟进行肾移植的尿毒症患者,根据左心室构型不同分为四组:左心室构型正常组(Left ventricular normal geometric, LVN组);左心室向心性重构组(Left ventricular Centripetal remodeling, LV-CR组);左心室向心性肥厚组(Left ventricular Centripetal hypertrophy, LV-CH组,)和左心室离心性肥厚组(Left ventricular Eccentric hypertrophy,LV- EH组)。另择24例同期来我院体检指标正常者为对照组。测定并比较五组受试者的左心室三维整体应变参数—圆周峰值应变(Global circumferential strain,GCS)、径向峰值应变(Global radial strain,GRS)以及纵向峰值应变(Gobal longitudinal strain,GLS),比较五组参数间的差异。结果:①与对照组相比,尿毒症各组的GLS水平均减低、LV-CH、LV-EH组的GRS、GCS水平减低(P<0.05);与LVN组相比,LV-CH、LV-EH组GLS、GRS、GCS水平减低(P<0.05);与LV-CR组相比,LV-CH组GLS、GCS及LV-EH组GLS、GCS、GRS水平减低(P<0.05);与LV-CH组相比,LV-EH组GLS、GCS减低(P<0.05)。②根据ROC曲线显示:三维斑点追踪技术能很敏感的检测心肌重构功能,以GLS的敏感性最高。③重复性检验:3D-STI技术测定的GLS,在观察者内和观察者间测量的结果稳定,显示具有良好的一致性。结论:3D-STI技术可以有效评估肾移植前不同心室构型尿毒症患者的左心室收缩功能,有助于合理选择受体,制定个体化治疗方案,更好的改善患者预后。 |
关键词: 尿毒症 超声心动描记术 三维斑点追踪成像 心室功能,左 |
DOI: |
投稿时间:2021-11-30修订日期:2022-02-23 |
基金项目: |
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Evaluation of left ventricular systolic function in patients with uremia before renal transplantation by three-dimensional speckle tracking imaging |
Qi Yingxiang,Jiang Zhirong,Chen Xiaofei |
(Department of Cardiac Ultrasound,Hospital of Qingdao University,Qingdao,Shandong,266000) |
Abstract: |
Objective Three dimensional speckle tracking imaging technology (3D-STI) was used to evaluate the overall left ventricular systolic function of uremic patients with different ventricular configurations before renal transplantation, and to explore its clinical significance. Methods 85 uremic patients undergoing renal transplantation were divided into four groups according to different left ventricular configurations: left ventricular normal geometric (LVN group); left ventricular centripetal remodeling group (LV-CR group); left ventricular centripetal hypertrophy (LV-CH group) and left ventricular eccentric hypertrophy (LV-EH group). Another 24 cases with normal physical examination indexes in our hospital in the same period were selected as the control group. The three-dimensional global strain parameters of left ventricle in five groups were measured and compared - Global circumferential strain (GCS), global radial strain (GRS) and global longitudinal strain (GLS) were measured and compared. Results ① Compared with the control group, the levels of GLS in uremia group decreased, and the levels of GRS and GCS in LV-CH group and LV-EH group decreased (P < 0.05); Compared with LVN group, the levels of GLS, GRS and GCS in LV-CH group and LV-EH group decreased (P < 0.05); Compared with LV-CR group, the levels of GLS, GCS and GRS in LV-CH group and LV-EH group decreased (P < 0.05); Compared with LV-CH group, GLS and GCS inLV- EH group decreased (P < 0.05). ② According to ROC curve, three-dimensional speckle tracking technology can sensitively detect myocardial remodeling, and GLS is the most sensitive. ③ Repeatability test: the measurement results of GLS measured by 3D-STI technology within and between observers are relatively stable and have good consistency. Conclusion 3D-STI technology can effectively evaluate the left ventricular systolic function of uremic patients with different ventricular configurations before renal transplantation,help to reasonably select receptors, formulate individualized treatment plans, and better improve the prognosis of patients. |
Key words: Uremia Echocardiography Three- dimensional Speckle tracking imaging Ventricular function, left |
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