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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2016年第1期

页码:

77-081

栏目:

临床研究

出版日期:

2015-09-15

文章信息/Info

Title:

Evaluation of left ventricular function by strain rate imaging in patients with uremia

作者:

苏军芳¹; 张 军²; 王 银¹; 芮海荣³; 孙艳丹¹; 王章华³

(解放军第451医院：1.特诊科，3.透析中心，陕西 西安 710054；
2.第四军医大学西京医院超声科，陕西 西安 710032)

Author(s):

SU Jun-fang¹;  ZHANG Jun²;  WANG Yin¹;  RUI Hai-rong³;  SUN Yan-dan¹;  WANG Zhang-hua³

(1.Department of Special Diagnostics, 3.Hemodialysis Center, PLA 451 Hospital, Xi’an 710054, Shaanxi, China；
2.Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, Xian 710032, Shaanxi, China)

关键词:

尿毒症; 左心室功能; 应变率

Keywords:

uremia;  left ventricular function;  strain rate

分类号:

R692.5

DOI:

-

文献标识码:

A

摘要:

目的 应用应变率成像技术评价尿毒症患者左室的局部收缩与舒张功能。方法 40例尿毒症患者，左室肥厚(LVH)组25例，非左室肥厚（NLVH）组15例及30例正常对照组。取心尖四腔、心尖两腔、心尖左室长轴切面测量左室各室壁心肌收缩期、舒张早期、房缩期的峰值速度（VS、VE、VA）、峰值应变率(SRS、SRE、SRA)、最大应变及位移。结果 速度Vs、VA：尿毒症患者较正常对照组无显著性差异，VE：尿毒症患者NLVH组后间隔、下壁较正常对照组显著性减低，LVH组除后壁外余左室各壁较正常对照组显著性减低。尿毒症患者两组间仅在前间隔有显著性差异。应变率SRS：尿毒症患者LVH组左室侧壁较正常对照组显著性减低。SRE：尿毒症患者NLVH组左室侧壁、下壁、后壁较正常对照组显著性减低，LVH组除后间隔外左室各壁较正常对照组显著性减低。LVH组前间隔及前壁的SRE较NLVH组显著性减低。SRA：尿毒症患者较正常对照组无显著性差异。应变S：尿毒症患者NLVH组仅有左室侧壁较正常对照组有显著性差异，LVH组除后间隔外其余左室壁较对照组显著性减低。LVH组前壁的应变较NLVH组显著性减低。位移D：尿毒症患者NLVH组仅在后间隔较正常对照组显著性减低，LVH组后间隔、后壁、前间隔、下壁较正常对照组显著性减低（分别P<0.05和0.01）。结论 应变率成像技术能够早期评尿毒症患者左室的心肌运动功能。

Abstract:

AIM To evaluate local systolic and diastolic functions of left ventricle in patients with uremia using strain rate imaging (SRI) technique. METHODSIncluded in the study were 40 uremia patients: 25 patients with left ventricular hypertrophy (LVH) and 15 patients without left ventricular hypertrophy (NLVH), and 30 normal control subjects. Apical four-chamber, apical two-chamber and apical LV longitudinal views were taken to measure left ventricular wall myocardial peak velocity (VS, VE and VA), peak strain rate (SRS, SRE and SRA) ring systole and early diastole atrium contractions, and maximum strain and displacement. RESULTSNo significant difference was found in VS and VA between uremia patients and control subjects. VE at posterior interventricular septum (PS) and inferior wall (IW) in NLVH group was significantly lower than in normal control group. Those of other walls except posterior wall (PW) significantly decreased in LVH group. Significant difference was found in VE of anterior interventricular septum (AS) with uremia patients between LVH group and NLVH group. SRS of left ventricular lateral wall (LW) in LVH group was significantly reduced compared with those in normal control group. SRE of LW, IW and PW in NLVH group significantly decreased compared with those in normal control group. Except for that of PS, SRE of other walls in LVH group showed significant differences from those in normal control group. SRE of AS and anterior wall (AW) in LVH group significantly decreased compared to NLVH group. No significant difference was found in SRA between uremia patients and normal control group. Strain of LW in NLVH group was significantly different from that in normal control group. Except for that of PS, strain of other walls in LVH group showed a significant difference compared with that in control group. Displacement of PS in NLVH group was significantly reduced compared with that in normal control group. Strain of AW in LVH group was significantly lower than in NLVH group. Displacement of PS, PW, anterior interventricular septum and IW in LVH group significantly decreased compared with that in normal control group (P<0.05 and 0.01, respectively). CONCLUSIONStrain rate imaging can be used early for evaluation of left ventricular myocardial functions in patients with uremia.

参考文献/References

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备注/Memo

备注/Memo:

收稿日期：2014-12-11.
>基金项目：陕西省课题资助（2013K12-20-07）
通讯作者：张军，教授，主要从事心血管超声的研究 Email：zhangjun@fmmu.edu.cn
作者简介：苏军芳，副主任医师，硕士 Email:sujunfang@126.com

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更新日期/Last Update: 2015-09-16