组织多普勒成像心肌做功指数定量评价慢性肾衰患者左室功能

目的探讨组织多普勒成像(TDI)测定心肌做功指数(Tei指数)在定量评价慢性肾衰患者(CRF)左室功能中的价值。方法前瞻性连续纳入CRF患者40例,根据肾功能损害程度分为两组:氮质血症组18例,肾功能衰竭组22例,并选取40例健康人作为对照组。分别测量3组左心室常规超声心动图参数,并应用TDI技术测算左心室Tei指数并进行比较。结果①氮质血症组、肾功能衰竭组和正常对照组的Tei指数分别为0.46±0.12、0.53±0.15和0.41±0.09,组间比较均具有差异性(P0.05)。氮质血症组和肾功能衰竭组患者分别与正常对照组Tei指数比较差异有统计学意义(P均0.05),且肾功能衰竭组患者的Tei指数较氮质血症组患者显著增大(P0.05),临床表现为舒张功能障碍;②肾功能衰竭组左心室等容收缩时间(ICT)/左室射血时间(ET)明显高于正常对照组(P0.05),氮质血症组和肾功能衰竭组等容舒张时间(IRT)/ET显著高于正常对照组(P0.01)。结论 Tei指数是一种综合评估心功能敏感性、特异性和重复性较好的指标。应用Tei指数综合评价CRF患者心脏的整体功能,为CRF患者的心功能早期改变提供可靠诊断依据。

Tissue doppler cardiac work index quantitative assessment of left ventricular function in patients with chronic renal failure

Objective To evaluate the value of tissue doppler imaging （TDI） measurement index of cardiac work （Tei index） in quantitative evaluation of patients with chronic renal failure （CRF） the value of left ventricular function. Methods 40 CRF patients were included into this study. All these patients were divided into two groups according to the degree of renal impairment： nitrogen mass disease group 18 cases, renal failure group 22 cases, and healthy control group 40 cases （control group）. The left ventricular routine echocardiographic parameters were compared among the three groups, application of TDI technique measure left ventricular Tei index and compare. Results （1）The Tei index of nitrogen mass disease group, renal failure group and normal control group was （0. 46 ± 0. 12 ）, （0.53± 0.15 ）, and （0. 41 ±0. 09 ）, respectively. There were significant differenee among the three groups （ P 〈 0. 05 ）. The Tel index of renal failure group and nitrogen mass disease group patients were different from that of normal group patients. There was statistically significant （ P 〈0. 05 ）. The Tei index of renal failure group is higher than that of nitrogen mass disease group （ P 〈0. 05 ）. The clinical manifestation included mainly diastolic dysfunction. （2）The left ventricular ICT/ET of renal failure group was obviously higher than that of normal control group （ P 〈 0.05 ）. The left ventricular IRT/ET of renal failure group and nitro- gen mass disease group was significantly higher than that of normal control group （ P 〈 0. 01 ）. Conclusion Tei index is a kind of comprehensive evaluation of cardiac function sensitivity, specificity and good repeatability. Tei index comprehensive evaluation of the integrated function of the CRF patients with heart, early change for cardiac funetion of patients with CRF provide reliable diagnostic basis.