实时三维超声心动图评价尿毒症性心肌病左心室收缩功能及同步性

目的:探讨实时三维超声心动图(RT-3DE)评价尿毒症性心肌病(UM)患者左心室收缩功能及其同步性的应用价值。方法:①对30例尿毒症性心肌病患者和20例正常对照组采用RT-3DE采集其左心室容积和射血分数,同时应用二维超声心动图Si mpson法、M型Teichholz法进行检测,将三种方法所测的数据与磁共振显像技术所测的数据进行比较;②RT-3DE检查获取左心室全容积图像,应用QLAB4.2软件分析左心室17节段达到收缩期最小容积点时间(Tmsv)的标准差(Tmsv16-SD、Tmsv12-SD和Tmsv6-SD)及最大时间差(Tmsv16-Dif、Tmsv12-Dif和Tmsv6-Dif),对标准差及最大时间差行心率校正。结果:①UM组Teichholz法、Si mpson法所测LVEDV和LVESV均高于或低于RT-3DE测值,其差异均有统计学意义(P0.05);②正常组与UM患者16节段、12节段(中间段和基底段)和6节段(基底段)Tmsv的标准差和最大时间差值均有显著性差异,UM组均大于正常组(P0.05或P0.01)。结论:①在UM患者中,RT-3DE法的左室容积及射血分数数据准确性高;②RT-3DE为临床评价UM患者左心室收缩同步化及收缩功能提供了更加快速、简便、准确及无创性的新方法。

Evaluation of the left ventricular systolic function and synchrony in patients with uremic myocardiopathy using real-time three-dimensional echocardiography

Objective：To explore the application value of real-time three-dimensional volume quantitative technique（RT-3DE） on the left ventricular systolic function and synchrony of uremic myocardiopathy patients.Methods：① 30 cases of UM patients and 20 normal subjects were enrolled in this study.We use RT-3DE to obtain the left ventricular volume and ejection fraction,while using Simpson method and M-Teichholz method.The results of the three methods was compared.Meanwhile,MRI technology with the measured data for comparison;② We also use RT-3DE to obtain the left ventricular full-volume image and QLAB 4.2 software to analyze data.Results：① In the the results of LVEDV and LVESV measured by M-Teichholz method and Simpson method were higher or lower than the measured by RT-3DE method,and the differences were statistically significant（P0.05）;② As to Tmsv 16-SD,Tmsv 16-Dif,Tmsv 12-SD,Tmsv 12-Dif,Tmsv 6-SD,Tmsv 6-Dif,Group UM is higher than normal group（P0.05 or P0.01）.Conclusion：① In UM patients,the result of RT-3DE is higher accuracy compared with Simpson method and M-type method in LVEDV and EF;② RT-3DE provides a simple,repeatable and non-invasive new method to assess the LV systolic function and synchrony in patients of UM.