| 摘要: |
| 目的 应用二维斑点追踪技术（2D-STI）及右室量化分析系统评价保留左室射血分数（LVEF）的尿毒症患者透析前后右室收缩功能。方法 选取在我院肾内科确诊尿毒症并进行规律血液透析患者40例为血透组，分为透析前和透析后，另外选35例健康体检者作为对照组。常规超声心动图测量左室射血分数（LVEF）、右室舒张末期内径（RVEDD）、三尖瓣环收缩期峰值流速（S’）、三尖瓣环收缩期位移(TAPSE)、面积变化分数(FAC)；二维斑点追踪技术测量右室整体纵向应变(RVGLS)、右室游离壁纵向应变（RVFWLS）、右室室间隔纵向应变（RVSLS）；右室量化分析系统测量右室舒张末期容积(RVEDV)、右室收缩末期容积(RVESV)、右室射血分数(RVEF)，比较上述各组间参数差异。结果 与正常对照组相比，尿毒症患者透析前和透析后RVEDV、RVESV均增大，LVEF、RVGLS、RVFWLS、RVSLS、TAPSE、FAC、RVEF均减小,差异有统计学意义（P<0.05）；尿毒症患者透析前和后RVEDD、S’差异没有统计学意义（P>0.05）。与透析组患者透析前相比，透析后RVESV、RVEDV均减小，RVGLS、RVFWLS、RVSLS、RVEF均增大,差异有统计学意义（P<0.05）；透析后TAPSE、FAC差异没有统计学意义（P>0.05）。在相关性分析中，RVEF与RVGLS、RVFWLS、RVSLS的绝对值呈正相关，相关性系数分别为0.683，0.702，0.476。结论 二维斑点追踪技术联合右室量化分析系统可以评价保留LVEF的尿毒症患者透析前后右室收缩功能。 |
| 关键词: 斑点追踪 尿毒症 右室 收缩功能 |
| DOI： |
| 投稿时间：2022-08-24修订日期：2023-02-24 |
| 基金项目:国家自然科学基金(81670301);安徽省高等学校省级质量工程项目(2020xskt525);安徽省高等学校省级质量工程项目(2020xsxxkc458) |
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| Evaluation of right ventricular systolic function in uremic patients before and after dialysis by two-dimensional speckle tracking imaging and right ventricular quantitative analysis system |
| LIAN Feifei,LIU Biaohu,JI Wenyan,DING Jing,TAO Shanqiang,YANG you |
| (Department of ultrasound,Yijishan Hospital,Wannan Medical College,Anhui,241000;China) |
| Abstract: |
| Objective To evaluate the right ventricular systolic function before and after dialysis in uremic patients with preserved left ventricular ejection fraction(LVEF) by using two-dimensional speckle tracking imaging(2D-STI) and right ventricular quantitative analysis system. Methods 40 patients with uremia diagnosed in the nephrology department of our hospital and undergoing regular hemodialysis were selected as the hemodialysis group.They were divided into pre dialysis and post dialysis groups.Another 35 healthy people were selected as the control group.Left ventricular ejection fraction(LVEF),right ventricular end diastolic diameter(RVEDD),tricuspid annular systolic peak flow velocity(S’),tricuspid annular plane systolic excursion(TAPSE),FAC(fractional area change) were measured by conventional echocardiography;right ventricular global longitudinal strain(RVGLS),right ventricular free wall longitudinal strain(RVFWLS) and right ventricular septal longitudinal strain(RVSLS) were measured by two-dimensional speckle tracking imaging;right ventricular end diastolic volume(RVEDV),right ventricular end systolic volume(RVESV) and right ventricular ejection fraction(RVEF) were measured by the right ventricular quantitative analysis system.Compare the differences between the above groups of parameters.Results Compared with the normal control group,the values of RVEDV and RVESV in uremic patients were increased before and after dialysis,and the values of LVEF,RVGLS,RVFWLS, RVSLS, TAPSE, FAC and RVEF were decreased(P<0.05);There was no significant difference in RVEDD and S’ between uremic patients before and after dialysis(P>0.05).Compared with the patients in the dialysis group before dialysis,the values of RVESV and RVEDV after dialysis were decreased,and the values of RVGLS,RVFWLS,RVSLS and RVEF were increased,with statistical significance(P<0.05);There was no significant difference in TAPSE and FAC after dialysis(P>0.05).In the correlation analysis,the absolute values of RVEF and RVGLS,RVFWLS and RVSLS were positively correlated,and the correlation coefficients were 0.683,0.702 and 0.476 respectively.Conclusion Two-dimensional speckle tracking imaging combined with right ventricular quantitative analysis system can evaluate the right ventricular systolic function before and after dialysis in uremic patients with preserved LVEF. |
| Key words: Speckle tracking ?Uremia ?Right ventricle Systolic function |
