终末期肾病患者左心房功能改变及与左心室功能的相关性研究

发布时间：2018-07-02 22:51

本文选题：肾病 + 心房功能　；参考：《中国全科医学》2017年35期

【摘要】：目的应用左心房容积追踪(LAVT)技术研究终末期肾病(ESRD)患者左心房功能的变化,以及左心房功能与左心室功能的相关性。方法选取2014年12月—2016年10月于天津市第一中心医院行血液透析的ESRD患者65例为ESRD组,另选择同期经体格检查、实验室检查、心电图及超声心动图检查均无异常的志愿者58例为对照组。采用彩色超声诊断仪,配备LAVT技术软件包,测量常规超声心动图指标左心室射血分数(LVEF)、左心室短轴缩短率(FS)、左房室瓣E峰最大流速(E)、瓣环运动速度(e'),以及左心房功能指标,即经体表面积标化的左心室收缩末期左心房最大容积(LAVImax)、心电图p波对应容积(LAVIp)、左心室舒张末期左心房最小容积(LAVImin)和左心房整体排空率(LATEF)、左心房被动排空率(LAPEF)、左心房主动排空率(LAAEF)。结果ESRD组LVEF、左心室FS、E、e'低于对照组,E/e'高于对照组(P0.05)。ESRD组LAVImax、LAVIp、LAVImin、LATEF、LAAEF高于对照组,LAPEF低于对照组(P0.05)。ESRD组左心房功能指标LATEF与LVEF呈负相关,LAVImax、LAVIp、LAVImin、LATEF、LAAEF与E/e'呈正相关(P0.05)。ESRD组左心房功能指标LAVImax与LAVIp、LAVImin、LATEF呈正相关,LAVImin与LATEF呈正相关,LATEF、LAPEF与LAAEF呈正相关(P0.05)。结论 ESRD患者左心房储器功能、助力泵功能增加,管道功能减低,且储器功能在左心室舒张早期充盈中起重要作用,而助力泵功能在左心室主动充盈中具有关键作用。
[Abstract]:Objective to study the changes of left atrial function and the correlation between left atrial function and left ventricular function in patients with end-stage nephropathy (ESRD) by left atrial volume tracing (LAVT). Methods Sixty-five ESRD patients undergoing hemodialysis in Tianjin first Central Hospital from December 2014 to October 2016 were selected as ESRD group. The control group consisted of 58 volunteers who had no abnormal ECG and echocardiography. Left ventricular ejection fraction (LVEF), left ventricular shortening rate (FS), left atrioventricular peak E velocity (E), annular velocity (E') and left atrial function were measured by color echocardiography with LAVT software package, and the parameters of left ventricular ejection fraction (LVEF), left ventricular shortening rate (FS), left atrioventricular valve velocity (E') and left atrial function were measured. That is, the maximal left atrial volume (LAVImax), the corresponding volume of p wave (LAVIp), the minimum volume of left ventricular end-diastolic atrium (LAVImin), the left atrial global emptying rate (LATEF), the left atrial passive emptying rate (LAPEF), the left atrial active emptying rate (LAAEF). Results in ESRD group, LVEF, left ventricular FSSI Ele 'were significantly lower than those in control group (P0.05). The LAVImaxLAVIpLAVIminLATEFEFLAAEF in ESRD group was higher than that in control group (P0.05). The left atrial function index LATEF and LVEF in ESRD group were negatively correlated with LVEF in ESRD group (P0.05). The left atrial function index LAVImax and LAVImin-LATEF in ESRD group were positively correlated with the left atrial function index (P < 0.05). The left atrial function index of ESRD group was positively correlated with LAVImax and LAVImin-LAVImin-LATEF in ESRD group (P0.05). The left atrial function index (LATEF) in ESRD group was negatively correlated with LVEF in ESRD group (P0.05). There was a positive correlation between LAVImin and LATEF. LAPEF was positively correlated with LAAEF (P0.05). Conclusion left atrial storager function, booster pump function and conduit function are increased in patients with ESRD, and the storage function plays an important role in early left ventricular diastolic filling, while the booster pump function plays a key role in left ventricular active filling.
【作者单位】：天津市第一中心医院超声科;
【基金】：天津市卫计委科技基金(2015KZ031)
【分类号】：R445.1;R692

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