三维斑点追踪成像技术评价尿毒症腹膜透析患者右心室功能的价值

发布时间：2017-12-30 20:02

本文关键词：三维斑点追踪成像技术评价尿毒症腹膜透析患者右心室功能的价值　出处：《山东医药》2016年04期 　论文类型：期刊论文

【摘要】：目的探讨三维斑点追踪技术评价尿毒症腹膜透析患者右心室功能的价值。方法选取腹膜透析患者35例(透析组)及同期健康体检者26例(对照组)。采用常规二维超声测算对照组、透析组透析前和透析3~6个月(透析后)左心室舒张期末内径(LVIDd)、左心室收缩期末内径(LVISd)、室间隔厚度(IVSd)、左心室射血分数(LVEF)、舒张期右心室基底部内径(basal RVd)、右心室面积变化分数(RVFAC)和肺动脉收缩压(PASP);三维斑点追踪成像技术测算右心室整体纵向收缩期峰值应变(RVGLS)、右心室整体圆周收缩期峰值应变(RVGCS)、右心室整体径向收缩期峰值应变(RVGRS)、右心室整体面积收缩期峰值应变(RVGAS)、右心室收缩期末容积(RVESV)、右心室舒张期末期容积(RVEDV)及右心室射血分数(RVEF)。结果常规二维超声测算结果:与对照组比较,透析组透析前LVIDd、LVISd、IVSd、PASP升高(P0.05或0.01),LVEF及右心室大小无明显变化(P均0.05);透析组透析前后比较,以上指标比较差异无统计学意义(P均0.05)。三维斑点追踪成像技术测算结果:与对照组比较,透析组透析前RVGLS、RVGAS、RVGCS、RVGRS绝对值明显降低(P均0.05),RVEDV、RVESV明显升高(P均0.05),RVEF无明显变化(P0.05);与透析组透析前比较,透析后RVEDV、RVESV明显减小(P均0.05),RVGLS绝对值明显升高(P0.05)。结论应用三维斑点追踪成像技术可发现尿毒症患者在RVEF正常时就已经出现右心室RVGLS、RVGRS、RVGCS、RVGAS的显著降低,及RVEDV、RVESV的显著增大;RVGLS可作为尿毒症患者腹膜透析右心室功能早期改善的一项重要指标。
[Abstract]:Objective to evaluate the value of three dimensional dot tracing technique in evaluating right ventricular function in uremic peritoneal dialysis patients. Methods 35 patients with peritoneal dialysis (dialysis group) and 26 healthy persons (control group) were selected. Routine two-dimensional ultrasound was used to measure the control group. Left ventricular end-diastolic diameter (LVIDdN), left ventricular end-systolic diameter (LVISdD) and interventricular septal thickness (IVSd) were observed before and 3 ~ 6 months after dialysis in the dialysis group. Left ventricular ejection fraction (LVEF), basal diameter of right ventricular base during diastolic period (RVFAC), right ventricular area change fraction (RVFAC) and pulmonary systolic pressure (PASP); Three-dimensional speckle tracing imaging was used to measure the peak strain of the whole longitudinal systolic phase of the right ventricle (RVGLSX) and the peak strain of the whole circumferential phase of the right ventricle (RVGCSs). RVGRSs, RVGASA, RVGASA and RVESVV at the end of right ventricular systolic period. Results: compared with the control group, the LVIDdT LVISd of the dialysis group was compared with that of the control group, and the right ventricular end-diastolic volume (RVEDVV) and the right ventricular ejection fraction (RVEFV) were measured by conventional two-dimensional ultrasound. There was no significant change in LVEF and right ventricular size (P 0.05). There was no significant difference in the above indexes before and after dialysis in the dialysis group (P < 0.05). The results of 3D speckle tracing imaging: compared with the control group, the RVGLS before dialysis in the dialysis group was higher than that in the control group. The absolute value of RVGRS in RVGASS decreased significantly (P < 0.05) and RVEDVV / RVESV increased significantly (P = 0.05). There was no significant change in RVEF (P 0.05). Compared with those before dialysis, RVEDVV / RVESV decreased significantly after dialysis (P < 0.05). The absolute value of RVGLS was significantly higher than that of P0.050.Conclusion the right ventricular RVGLSS-RVGRS can be found in uremic patients when RVEF is normal by using 3D speckle tracing imaging. The RVGAS of RVGCSS decreased significantly, and the RVESV of RVEDVV increased significantly. RVGLS may be an important index for early improvement of right ventricular function in peritoneal dialysis in uremic patients.
【作者单位】：苏州大学附属第二医院;
【分类号】：R692.5
【正文快照】： 心血管疾病是尿毒症腹膜透析患者最常见的死亡原因[1]。尿毒症患者透析前心脏病变已经存在,主要表现为心肌重构和心功能减退,既往对尿毒症长期腹膜透析患者左心室功能改变的研究较多[2],对其右心功能改变的研究较少。右心系统形态特殊,心脏磁共振目前被认为是右心功能评价的金

【相似文献】