| 摘要: |
| 目 的? 应用左室压力-应变环(PSL)技术量化评价终末期肾病患者的左室心肌做功指数(MWI),并根据治疗方式不同进行分组,旨在对比研究不同透析方式对左室MWI的影响。 方 法? 选取79例慢性肾病5期患者,年龄56.41±13.43岁,其中男42例,女37例。根据治疗方式不同,分为血透组(n=29)、腹透组(n=27)、未透组(n=23),分别比较三组患者的一般临床资料、常规超声心动图测量参数、左心室整体纵向应变(GLS)、以及心肌做功指数(MWI)包括整体做功指数(GWI)、整体有效功(GCW)、整体无效功(GWW)、整体做功效率(GWE)；并且分析MWI与各参数的相关性及其独立预测因子。结 果? 三组患者的年龄、性别、身高、体重等其他一般临床资料、常规超声心动图测量参数、GLS测值比较差异均无统计学意义(均P>0.05)。血透组GWI、GCW明显低于腹透组及未透组,GWW明显高于腹透组及未透组,GWE明显低于腹透组,差异有统计学意义(均P<0.05)。GWI、GCW与GLS、左室射血分数(LVEF)、收缩压、舒张压呈正相关,与室间隔厚度(IVS)、透析时间、透析方式(腹透为1,血透为2)呈负相关；GWW与透析方式呈正相关,与GLS呈负相关；GWE与GLS、LVEF呈正相关；与IVS、左室后壁厚度(LVPW)、透析方式呈负相关(P<0.05)。GWI、GWE的独立负向预测因子分别是透析时间及透析方式,GWW的独立正向预测因子是透析方式。 结 论? 血液透析较腹膜透析对左室收缩功能影响更大,MWI能够较常规超声心动图及GLS,更早期发现该类患者的左室心肌收缩功能受损。 |
| 关键词: 压力-应变环 透析 终末期肾病 |
| DOI： |
| 投稿时间：2023-10-24修订日期：2023-11-20 |
| 基金项目:安徽省高校自然科学研究重大项目(编号:KJ2020ZD22) |
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| Evaluation of left ventricular systolic function in end-stage renal disease patients on dialysis using pressure–strain loop analysis |
| wu ting ting |
| () |
| Abstract: |
| Abstract Objective To evaluate the effects of hemodialysis (HD) and peritoneal dialysis (PD) on left ventricular myocardial work indices (MWIs) in patients with end-stage renal disease using left ventricular pressure–strain loop (PSL) analysis. Methods 79 patients with stage 5 chronic kidney disease were grouped according to dialysis status: HD (n = 29), PD (n = 27), and no dialysis (ND; n = 23). Clinical data, laboratory and conventional echocardiographic parameters, global longitudinal strain (GLS), and the following MWIs were compared between groups: global work index (GWI),
global constructive work (GCW), global waste work, and global work efficiency (GWE). Correlations between the
MWIs and clinical parameters were analyzed as were MWI predictors. Results Age, gender, height, weight, other clinical characteristics, conventional echocardiographic parameters, and GLS values did not significantly differ between the three groups (all P >0.05). In the HD group, GWI and GCW were significantly lower than the PD and ND groups , GWW was significantly higher than the PD and ND groups, GWE was significantly lower than the PD group(both P <0.05) . GWI and GCW were positively correlated with GLS, left ventricular ejection fraction, systolic blood pressure, and diastolic blood pressure, but negatively correlated with interventricular septum thickness, dialysis time, and dialysis type(PD was denoted by 1, and HD by 2). Global waste work (GWW) was positively correlated with dialysis type, negatively correlated with GLS. GWE was positively correlated with GLS and left ventricular ejection fraction，while it was negatively correlated with dialysis type, interventricular septum thickness, and left ventricular posterior wall thickness (all P <0.05). Dialysis time and type were independent negative predictors of GWI and GWE respectively, Dialysis type was independent positively predictors of GWW. Conclusion HD has a greater impact on left ventricular systolic function than PD. PSL analysis can detect left ventricular systolic function impairment earlier than conventional echocardiography and GLS. |
| Key words: Pressure–strain loop, Dialysis, End-stage renal disease |
