三维斑点追踪技术评价不同时期慢性肾病患者左心室收缩功能

发布时间：2018-06-06 19:14

本文选题：超声心动描记术 + 三维　；参考：《中国医学影像技术》2015年12期

【摘要】：目的采用三维斑点追踪技术(3D-STI)评价不同时期慢性肾病(CKD)患者的左心室收缩功能。方法收集90例CKD患者并按肾小球滤过率将其分为早期组、中期组、晚期组,各30例,另选取30名健康人作为对照组。均采用3D-STI测量左心室整体纵向应变(GLS)、左心室整体径向应变(GRS)、左心室整体圆周应变(GCS)及左心室整体面积应变(GAS),比较4组间的差异。绘制ROC曲线,评价采用GLS及GAS检测早期CKD患者左心室收缩功能异常的敏感度及特异度。结果①与对照组相比,3组CKD患者的GLS和GAS均降低(P均0.05);晚期组GLS、GAS较早期组减低(P均0.05);②ROC曲线分析:采用GAS判定早期CKD患者左心室收缩功能异常的ROC曲线下面积为0.85,以30.5为截断值时,其敏感度为88.5%,特异度为81.0%;而采用GLS时的ROC曲线下面积为0.67,以-18.5为截断值时,其敏感度为84.6%,特异度为80.0%。结论 3D-STI可用以评价不同时期CKD患者的左心室收缩功能,其中GLS、GAS是诊断其收缩功能较好的指标,并可为早期检测出CKD患者左心室收缩功能异常提供定量指标。
[Abstract]:Objective to evaluate left ventricular systolic function in patients with chronic nephropathy (CKD) by using 3D-STI technique. Methods 90 patients with CKD were divided into three groups according to glomerular filtration rate: early group, middle group, late stage group, 30 cases each, and 30 healthy persons were selected as control group. Left ventricular global longitudinal strain (GLSN), left ventricular global radial strain (GRSs), left ventricular global circumferential strain (GCSS) and left ventricular global area strain (GASA) were measured by 3D-STI. The differences among the four groups were compared. To evaluate the sensitivity and specificity of GLS and gas in detecting abnormal left ventricular systolic function in early CKD patients. Results 1Compared with the control group, the GLS and gas of CKD patients in the 3 groups were lower than that of the control group (P < 0.05), and GLSN gas in the late group was lower than that in the earlier group (P < 0.05). The area under the ROC curve of gas was used to judge the abnormal left ventricular systolic function in the early CKD patients. Is 0.85, with a truncation value of 30.5, The sensitivity was 88.5 and the specificity was 81.0, while the area under the ROC curve was 0.67 when GLS was used, and the sensitivity and specificity were 84.6 and 80.0when the truncation value was -18.5. Conclusion 3D-STI can be used to evaluate left ventricular systolic function in patients with CKD at different stages. GLSlgas is a good index for diagnosing left ventricular systolic function, and it can provide quantitative index for early detection of left ventricular systolic function abnormality in CKD patients.
【作者单位】：黑龙江中医药大学附属第二医院放射科;哈尔滨医科大学附属第二医院超声医学科;
【分类号】：R445.1;R692

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