摘要
目的探讨心肌作功指数(Tei指数)评价慢性肾衰竭患者左室整体功能的临床价值。方法慢性肾衰竭患者51例,根据肾功能损害程度分为3组:氮质血症组(Ⅰ)、肾衰竭组(Ⅱ)和尿毒症组(Ⅲ),对照组(Ⅳ)30例,M型超声心动图分别测量左室舒张末期内径(LVEDd),室间隔、左室后壁厚度(IVST、LVPWT),输入患者身高及体重计算心肌重量指数(LVMI);二维超声心动图心尖四腔切面以Simpson法测定左室射血分数(LVEF%);频谱多普勒测量二尖瓣口舒张早期和舒张晚期血流峰值并计算E/A比值,测量E峰减速时间(DT);测量二尖瓣口相邻两个频谱相距的时间(a)及左室射血时间(b),根据公式Tei=(a-b)/b计算Tei指数。结果Ⅰ组IVST、LVPWT、LVEDd以及LVMI均与对照组无显著性差异;Ⅱ组IVST、LVPWT较对照组增厚(P<0.05),LVEDd与对照组无显著性差异;Ⅲ组IVST、LVPWT、LVEDd均与对照组有显著性差异(P<0.05)。Ⅱ组及Ⅲ组LVMI较对照组增加(P<0.05)。各组EF值与对照组比较均无显著性差异。Ⅰ组E/A比值与对照组比较无显著性差异,Ⅱ、Ⅲ组E/A比值与对照组比较差异显著(P<0.05);Ⅰ组Tei指数与对照组比较无显著性差异,Ⅱ、Ⅲ组Tei指数与对照组比较差异显著(P<0.05)。相关分析显示:Tei指数与LVMI(r=0.72,P<0.05)及IRT+ICT(r=0.59,P<0.05)呈正相关。结论慢性肾衰竭患者随肾功能损害程度加重左心重量指数增加;处于治疗状态的各阶段慢性肾衰竭主要以舒张功能减退为主。左心Tei指数有随肾功能损害程度加重而逐渐增大的趋势,且与左室重量指数呈正相关,该指数可作为评定左心整体功能的敏感指标。
Objective To investigate the value of myocardial performance index for estimating left ventricular global function in patients with chronic renal failure. Methods This study included 51 patients with chronic renal failure divided into three groups., azotemia （group I ）, renal failure （group Ⅱ ）, and uremia （group Ⅲ ）, and 30 normal subjects as the control group （group Ⅳ）. The conventional parameters included., the diastolic diameters of left ventricle （LVEDd）, the thickness of interventricular septum （IVST） and left ventricular posterior wall （LVPWT）, MV-E/A ratio, E peak deceleration time （DT）, ejection fraction （EF）, and interval between cessation and onset of mitral inflow （a） and the ejection time of LV outflow （b）. Left ventricular mass index （LVMI） were calculated; Tei indexs were calculated using the formula Tel index= （a -b）/b. Results The IVST, LVPWT, LVEDd and LVMI of group I were not distinctly different compared with controis. The IVST, LVPWT and LVMI were significantly increased in group Ⅱ and group Ⅲ. The LVEDd was significantly increased in group Ⅲcompared with that of controls. The LVEF were all within normal range in all four groups. The E/A and Tel index of group I were not different compared with controls. However,the E/A and Tei index were significantly in- creased in group Ⅱ and group Ⅲ compared with those of controls. Tel index of LV had positive relation with LVMI （r= 0.72, P〈0.05） and IRT＋ICT （r=0.59, P〈0.05）. Conclusion LVMI increases in patients with chronic renal failure as their renal function decreases. In the case of the left ventricle function, the diastolic function first decreases, then the systolic function goes down. Tei index of left ventricle tends to increase with the severity of the renal failure, and shows positive correlation with LVMI. It can be used as a sensitive index to evaluate the left ventricular global function.
出处
《中国医学影像技术》
CSCD
北大核心
2008年第7期1051-1053,共3页
Chinese Journal of Medical Imaging Technology
关键词
肾功能哀竭
慢性
超声心动描记术
心肌作功指数
心室功能
左
Kidney failure, chronic
Echocardiography
Myocardial performance index
Ventricular function, left
