实时三维超声心动图对维持性血液透析患者左心功能的评价

目的:以磁共振显像(MRI)技术为对照标准,探讨实时三维超声心动图（RT-3DE）评价维持血液透析（MHD）患者的左心室容积(LVV)和射血分数(LVEF)的可行性与准确性。方法：MHD患者48例,采用RT-3DE采集其LVV和LVEF，同时应用二维超声心动图Simpson’s法M-Teichholz法进行检测，将3种方法的检测值与MRI所检测的数据进行比较。结果：①RT-3DE容积检测值和MRI测量的LVV有良好的相关性（r=0.90，P<0.001）,配对t检验表明，两者检测值之间差异无显著性(P>0.05)。②在心腔变形时，M-Teichholz、Simpson’s法所测左室舒张末期容积（LVEDV）和左室收缩末期容积（LVESV）均高于或低于RT-3DE检测值,差异均有显著性(均P<0.05)。结论:RT-3DE可准确测量正常心腔及心腔变形情况下的LVV,在心腔变形情况下,RT-3DE较M-Teichholz、Simpson’s 法测得的LVV及LVEF数据准确性高。

Evaluation of left ventricular function in maintained hemodialysis patients using real-time three-dimensional echocardiography

Objective Using magnetic resonance imaging(MRI)technique as control standard,to explore the feasibility and accuracy of true real-time three-dimensional volume quantitative techniques(RT-3DE)in evaluation of the left ventricular volume(LVV)and left ventricular ejection fraction(LVEF)of the maintained hemodialysis(MHD)patients.Methods 48 MHD patients were enrolled in this study.RT-3DE was used to detect the LVV and LVEF,while Simpson's method and M-Teichholz method were used at the same time.The results of the three methods were compared with the data measured by MRI.Results ①The data measured by RT-3DE method showed a highly positive correlation with the LVV detected by MRI(r=0.90,P<0.001),but there was no significant difference between the two methods(P>0.05).②When heart cavity deformed,the results of left ventricular end-diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV)measured by M-Teichholz method and Simpson's method were higher or lower than the data measured by RT-3DE method,and the differences were statistically significant(all P<0.05).Conclusion RT-3DE can accurately measure the volume of normal cardiac chambers and the left ventricular cavity deformation volume.The result of RT-3DE has higher accuracy compared with Simpson's method and M-Teichholz method.