天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (11): 1203-1206.doi: 10.11958/20203570

• 应用研究 • 上一篇    下一篇

超声二维斑点追踪成像技术对尿毒症患者心室动脉偶联情况的评估价值

王小燕，朱雪峰，陆赵阳，昝玲娟，徐斌，陈鑫   

  1. 1苏州大学附属苏州九院（苏州市第九人民医院）超声科（邮编215200）；2南京市心血管医院心胸外科
  • 收稿日期:2020-12-28 修回日期:2021-07-21 出版日期:2021-11-15 发布日期:2021-11-19
  • 基金资助:
    国家自然科学基金资助项目（81870193）

The predictive value of two-dimensional ultrasonic speckle tracking imaging technology for ventricular arterial coupling in uremic patients

WANG Xiao-yan, ZHU Xue-feng, LU Zhao-yang, ZAN Ling-juan, XU Bin, CHEN Xin   

  1. 1 Department of Ultrasound, Suzhou Ninth People's Hospital Affiliated to Soochow University (Suzhou Ninth People's Hospital), Suzhou 215200, China; 2 Department of Cardiothoracic Surgery, Nanjing Cardiovascular Hospital
  • Received:2020-12-28 Revised:2021-07-21 Published:2021-11-15 Online:2021-11-19

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摘要： 目的　探讨超声二维斑点追踪成像（2DSTI）技术对尿毒症患者心室动脉偶联（VAC）情况的评估价值。方法　96例尿毒症患者按左心室射血分数（LVEF）分为LVEF正常组（LVEF≥0.55，48例）和LVEF下降组（LVEF＜0.55，48例）；另选取45例健康体检者作为健康对照组。所有患者均行常规超声心动图检查；测量心功能相关指标变化，计算VAC值。使用2DSTI测量左心室17节段的纵向应变值（LS），计算心底部纵向应变值（LSBA）、乳头肌纵向应变值（LSPM）和心尖部纵向应变值（LSAP）。结果　超声心动图结果显示，与健康对照组和LVEF正常组比较，LVEF下降组左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、左心室质量指数（LVMI）升高，左心室短轴缩短率（LVFS）、LSBA、LSPM和LSAP降低（P＜0.01）。2DSTI结果显示，与健康对照组和LVEF正常组比较，LVEF下降组左心室收缩末期弹性（Ees）下降，VAC值升高（P＜0.05）。相关性分析显示，尿毒症患者LSBA、LSPM、LSAP与Ees、LVEF、LVFS呈正相关（均P＜0.05），与有效动脉弹性（Ea）、VAC、外周血管阻力指数（SVRI）、心率血压乘积（RPP）、LVMI呈负相关（均P＜0.05）。结论　2DSTI可用于评估尿毒症患者的VAC情况。

关键词: 尿毒症, 超声心动描记术, 多普勒, 超声二维斑点追踪成像, 心室动脉偶联, 左心室射血分数

Abstract: Objective　To study the value of two-dimensional speckle tracing imaging (2DSTI) in the evealuation of ventricular-arterial coupling (VAC) in uremic patients. Methods　A total of 96 uremic patients were divided into two groups based on left ventricular ejection fraction (LVEF): the normal LVEF group (LVEF≥0.55, n=48) and the LVEF decline group (LVEF＜0.55, n=48). Forty-five healthy subjects were recruited as the control group. All the patients underwent conventional echocardiography. VAC and myocardial performance index were calculated. Longitudinal strain (LS) of 17 segments was measured using 2DSTI, and the longitudinal strain values of the bottom (LSBA), papillary muscle (LSPM) and apex (LSAP) were calculated. Results　Compared to subjects in the control group and the normal LVEF group, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular mass index (LVMI) were increased, and left ventricular short axis shorting rate (LVFS), LSBA, LSPM and LSAP were decline in the LVEF decline group (P＜0.01). 2DSTI results showed that compared with the control group and the normal LVEF group, Ees decreased and VAC value increased in the LVEF-decline group (P＜0.05). Correlation analysis showed that LSBA, LSPM and LSAP were positively correlated with Ees, LVEF and LVFS (all P＜0.05), and negatively correlated with effective arterial elasticity (Ea), VAC, peripheral vascular resistance index (SVRI), heart rate, blood pressure product (RPP) and LVMI (all P＜0.05). Conclusion　2DSTI can be used to evaluate VAC in uremia patients.

Key words: uremia, echocardiography, doppler, two-dimensional ultrasonic speckle tracking imaging, ventricular arterial coupling, left ventricular ejection fraction