摘要
目的探讨实时全容积三维超声心动图（RT-3DE）在评价尿毒症患者透析前后左室容积及功能变化中的应用价值。方法接受血液透析治疗的尿毒症患者40例为尿毒症组,体检健康者40例为对照组,于透析前和透析后1~2 h内,应用RT-3DE测量受检者左室容积及功能参数：左室舒张末容积（EDV）、收缩末容积（ESV）、每搏输出量（SV）、射血分数（EF）;舒张失同步指数（DDI16）、收缩失同步指数（SDI16）、平均舒张末期时间（MED16）、平均收缩末期时间（MES16）。结果透析前,与对照组比较,尿毒症组EDV较高,EF较低,SDI16、DDI16、MES16、MED16均较高（均P〈0.05）。透析后,尿毒症组EDV仍大于对照组,但较透析前减小;EF仍小于对照组,较透析前更小;SDI16、DDI16仍大于对照组,但较透析前减小（均P〈0.05）。结论血液透析治疗可以显著改善尿毒症患者体内因水钠潴留等原因导致的左室前负荷过重,同时可以在一定程度上改善左室节段性收缩及舒张功能。RT-3DE可以提供更多有意义的新指标,有重要的临床价值。
Objective To evaluate the value of full-volume and real-time three-dimensional echocardiography（RT-3DE） in assessment of left ventricular volume and function changes before and after dialysis in patients with uremia.Methods We scheduled 40 patients with uremia for blood dialysis treatment and 40 healthy cases as control group. Left ventricular volume and function parameters were measured by RT-3DE before dialysis and 1~2 h after dialysis. The parameters included end diastolic volume（EDV）,end systolic volume（ESV）,stroke volume（SV） and ejection fraction（EF）, diastolic dyssynchrony index（DDI16）, systolic dyssynchrony index（SDI16）,mean end-diastolic time（MED16） and mean end-systolic time（MES16）. Results Before dialysis, EDV, SDI16, DDI16, MES16 and MED16 were higher, and EF was lower compared with the control group, there were significant difference（P0.05）. After dialysis,EDV,SDI16 and DDI16 became lower but still higher than the control group, there were significant difference（P0.05）; EF became lower and was still lower than the control group, there was significant difference（P0.05）. Conclusion Blood dialysis treatment can significantly improve the left ventricular preload overweight of uremia patients due to reasons such as water or sodium retention. It can also improve left ventricular segmental systolic and diastolic function. Full-volume and real-time three-dimensional echocardiography can provide more meaningful indicators,which has crucial clinical significance.
出处
《临床超声医学杂志》
2016年第10期657-661,共5页
Journal of Clinical Ultrasound in Medicine
基金
河北省自然科学基金(H2015206405)
河北省高校强势特色学科―第四医院肿瘤学支持项目(冀教高[2005]52号)
关键词
超声心动描记术
三维
全容积
实时
心室功能
左
尿毒症
血液透析
Echocardiography
three-dimensional
full-volume
real-time
Ventricular function
left
Uremia
Dialysis
