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1. 中国人民解放军中部战区总医院超声科
2. 中国人民解放军中部战区总医院心血管内科
3. 武汉大学中南医院肾内科
纸质出版日期:2020,
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[1]杜锐,唐晓艳,钱胜利,杨莉,马洲,乔伟,黄炜.实时三维超声联合斑点追踪技术评价终末期慢性肾脏病患者右室收缩功能[J].临床超声医学杂志,2020,22(11):824-828.
DU Rui, TANG Xiaoyan, QIAN Shengli, et al. Evaluation of right ventricular systolic function by real-time three-dimensional echocardiography and speckle tracking imaging in end-stage renal dysfunction patients[J]. Journal of Clinical Ultrasound in Medicine, 2020,22(11):824-828.
[1]杜锐,唐晓艳,钱胜利,杨莉,马洲,乔伟,黄炜.实时三维超声联合斑点追踪技术评价终末期慢性肾脏病患者右室收缩功能[J].临床超声医学杂志,2020,22(11):824-828. DOI: 10.16245/j.cnki.issn1008-6978.2020.11.009.
DU Rui, TANG Xiaoyan, QIAN Shengli, et al. Evaluation of right ventricular systolic function by real-time three-dimensional echocardiography and speckle tracking imaging in end-stage renal dysfunction patients[J]. Journal of Clinical Ultrasound in Medicine, 2020,22(11):824-828. DOI: 10.16245/j.cnki.issn1008-6978.2020.11.009.
目的应用实时三维超声联合三维斑点追踪技术评估左室射血分数(LVEF)保留的终末期慢性肾脏病(ESRD)患者的右室收缩功能。方法选取我院血液净化中心规律血液透析的LVEF保留的ESRD患者43例
根据是否合并肺动脉高压分为ESRD组23例和ESRD合并肺动脉高压组20例;另选25例健康志愿者为对照组。应用常规超声测量各组右房横径(RAD)、右室基底部横径(RVD1)、右室中部横径(RVD2)、右室长径(RVD3)、主肺动脉内径(PAD)、LVEF及右室心肌做功指数(RIMP);实时三维超声测量右室舒张末容积(EDV)、右室收缩末容积(ESV)、每搏输出量(SV)、右室每分输出量(RVCO)、右室射血分数(3DRVEF)、面积变化分数(FAC)及三尖瓣环收缩期位移(TAPSE);三维斑点追踪技术获取右室游离壁整体纵向应变(3DGLS);比较各组上述各参数差异;分析3DGLS与右室收缩功能参数的相关性。结果与对照组比较
ESRD组及ESRD合并肺动脉高压组EDV、ESV、RVCO、RIMP均增大
3DRVEF、TAPSE、FAC均减低(均P<0.05);ESRD组RVD1、RVD2、RVD3差异均无统计学意义;ESRD合并肺动脉高压组RAD、RVD1、RVD2、PAD、SV均增大(均P<0.05)。与ESRD组比较
ESRD合并肺动脉高压组EDV、ESV、RVCO均增大
3DRVEF、TAPSE、FAC均减低(均P<0.05)。3DGLS绝对值在对照组、ESRD组、ESRD合并肺动脉高压组依次显著减低(P<0.01)。相关性分析显示
3DGLS的绝对值与3DRVEF、TAPSE、FAC均呈正相关(r=0.77、0.62、0.59
均P<0.01)
与RIMP呈负相关(r=-0.55
P<0.01)。结论实时三维超声联合三维斑点追踪技术可定量评估LVEF保留的ESRD患者右室收缩功能。
ObjectiveTo evaluate the right ventricular systolic function of patients with end-stage renal disease(ESRD)with normal left ventricular ejection fraction(LVEF)by real-time three-dimensional echocardiography and three-dimensional speckle tracking imaging.MethodsA total of 43 ESRD patients with normal LVEF on regular hemodialysis in theblood purification center of our hospital were selected
which were divided into the ESRD group(23 cases)and the ESRD withpulmonary hypertension group(20 cases)according to whether they were combined with pulmonary hypertension. Twenty-fivehealthy volunteers were enrolled as the control group. The right atrium diameter(RAD)
right ventricular basal diameter(RVD1)
right ventricular mid diameter(RVD2)
right ventricular longitudinal diameter(RVD3)
pulmonary artery diameter(PAD)
LVEF and right ventricular index of myocardial performance(RIMP)were measured by conventional echocardiography.The right ventricular end diastolic volume(EDV)
right ventricular end systolic volume(ESV)
stroke volume(SV)
rightventricular output per minute(RVCO)
3 D right ventricular ejection fraction(3 DRVEF)
fractional area change(FAC)andtricuspid annular plane systolic excursion(TAPSE) were measured by real-time three-dimensional echocardiography. Theglobal longitudinal strain of free wall(3 DGLS)was obtained by three-dimensional speckle tracking imaging. The differences ofthe above parameters were compared
and the correlation between 3 DGLS and right ventricular systolic function was analyzed.ResultsCompared with the control group
EDV
ESV
RVCO
RIMP were increased in ESRD group
3 DRVEF
TAPSE
FACwere decreased(all P<0.05).RVD1
RVD2
RVD3 in ESRD group were not statistically significant. RAD
RVD1
RVD2
PAD
SV were increased in ESRD with pulmonary hypertension group(all P<0.05).Compared with the ESRD group
EDV
ESV andRVCO in the ESRD with pulmonary hypertension group were increased
while the 3 DRVEF
TAPSE
FAC were decreased(allP<0.05). The absolute value of 3 DGLS decreased significantly in turn in ESRD group
ESRD with pulmonary hypertension groupand the control group(P<0.01). Correlation analysis showed that the absolute value of 3 DGLS was strongly positively correlatedwith 3 DRVEF
TAPSE
FAC(r=0.77
0.62
0.59
all P<0.01)
and negatively correlated with RIMP value(r=-0.55
P<0.01).ConclusionReal-time three-dimensional echocardiography and three-dimensional speckle tracking imaging can be appliedto evaluate the right ventricular systolic function of patients with LVEF-preserved ESRD.
超声心动描记术斑点追踪终末期肾病肺动脉高压收缩功能心室右
EchocardiographySpeckle trackingEnd-stage renal diseasePulmonary hypertensionSystolic functionventricleright
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