应变率成像技术对肾功能衰竭患者左房功能的评价

发布时间：2018-07-26 18:46

【摘要】：目的通过应变率成像技术(SRI)评价处于肾功能衰竭阶段患者的左心房功能。方法自2012年2月自2014年2月，选择肾功能衰竭患者50例，正常对照20例进行超声心动图检查。首先连接心电图，同步屏幕显示心电波形后，在二维模式下左室长轴切面测量收缩期左心房(LA)内径。于心尖切面采集四腔心三个心动周期图像存入仪器内，启动TDI模式，采集心尖四腔心、二腔心、三腔心各三个心动周期动态图像保存以备脱机分析。脱机分析，采用simpson法，测量左心房最大容积（LAmax），最小容积（LAmin），收缩前容积（Pla）以及左心房功能（left atriumejection fraction）LAEF，进入仪器自带Q-lab分析软件，取样容积设置0.2x0.4cm，取样位置设定于左心十字交叉上方1.0cm处，测量左心房房间隔、侧壁、前壁、下壁、后壁共5个位点应变率（SR），测量应变SRe、SRa、SRs峰值速度，记录。结果 1、常规超声心动图：肾功能衰竭组左房容积增大明显，大部分（50例中43例，占86%）患者左房收缩功能LAEF≥50%，只有（7例，占14%）少部分患者左房功能LAEF50%。 2、应变率成像：肾功能衰竭组与对照组比较，肾功能衰竭组应变率峰值SRe和SRs较对照组显著减低（P0.01），说明心房的管道功能及储存器功能受损，而两组应变率峰值SRa无显著差异（P0.05），说明肾功能衰竭组左房泵功能未受影响。 3、肾衰竭组应变率SRe/a1，而对照组SRe/a1，以下壁、前壁、后壁显著（P0.01） 4、肾功能衰竭组内，按50岁分界，两组应变率SRe，SRa，SRs均无显著差异（P0.05）结论肾功能衰竭可导致左心房功能异常，包括管道功能、储存器功能； SR能准确、快速定量检测肾功能衰竭患者左房的局部心肌的应变率变化，通过应变率各项指标评价心房功能，，为临床治疗提供重要依据。
[Abstract]:Objective to evaluate left atrial function in patients with renal failure by strain rate imaging (SRI). Methods from February 2012 to February 2014, 50 patients with renal failure and 20 normal controls were examined by echocardiography. The left ventricular long axis section was used to measure the (LA) diameter of the left atrium in two dimensional mode. The images of three cardiac cycles of four cavities were collected on the apical section and stored in the instrument, and the TDI mode was started, and the dynamic images of the apical four cavities, two cavities and three cavities were collected for off-line analysis. Off-line analysis, simpson method was used to measure the maximum volume of left atrium (LAmax), the minimum volume of (LAmin), (pre-systolic volume (Pla) and the left atrial function (left atriumejection fraction) LAEF, (left atriumejection fraction) LAEF,) into the Q-lab analysis software. The sampling volume was set at 0.2 x 0.4 cm, and the sampling position was set at 1.0cm above the cross of the left atrium. The left atrial septum, lateral wall, anterior wall, inferior wall and posterior wall were measured by strain rate (SR),. Results 1. Conventional echocardiography showed that left atrial volume was significantly increased in renal failure group. Left atrial systolic function (LAEF) was more than 50 in most of the patients (43 out of 50 cases, 86%), only 7 cases (7 cases). Strain rate imaging: peak strain rate SRe and SRs in renal failure group were significantly lower than those in control group (P0.01), which indicated that atrial conduit function and storage function were impaired. However, there was no significant difference in peak strain rate SRa between the two groups (P0.05), indicating that left atrial pump function was not affected in renal failure group. There was no significant difference in SRS between the two groups according to the age limit of 50 years (P0.05). Conclusion Renal failure can lead to abnormal left atrial function, including conduit function and storage function, SR can be accurate. The changes of local myocardial strain rate of left atrium in patients with renal failure were measured quickly and quantitatively. The evaluation of atrial function by various indexes of strain rate provided important basis for clinical treatment.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692.5

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