实时三平面自动功能成像评价尿毒症患者血液透析前后左心室长轴收缩功能

目的 探讨实时三平面自动功能成像（AFI）评价尿毒症患者透析前后左心室长轴收缩功能的价值。方法 收集接受血液透析的尿毒症患者30例（尿毒症组）和健康志愿者（对照组）32名，患者均于初次透析前、透析后1个月和3个月接受超声心动图检查；应用实时三平面AFI测量左心室各节段纵向收缩峰值应变（RLS）和整体纵向收缩峰值应变（GLS），比较尿毒症组与对照组AFI各指标差异，分析GLS与左心室心肌质量指数（LVMI）和左心室射血分数（LVEF）的相关性。结果 尿毒症组透析前、透析后1个月GLS和所有节段RLS，透析后3个月GLS及部分节段RLS明显低于对照组（P均<0.05）。尿毒症组透析后1个月和3个月GLS增高，部分节段RLS增高（P均<0.05）；与透析后1个月比较，透析后3个月GLS进一步增高，部分节段RLS进一步增高（P均<0.05）。GLS与LVMI呈负相关（r=-0.547，P<0.01），与LVEF呈正相关（r=0.252，P<0.01）。结论 实时三平面AFI可早期定量评价尿毒症患者左心室长轴收缩能力。

Real-time triplane automated function imaging in evaluating left ventricular long-axis systolic function in patients with uremia before and after hemodialysis

Objective To explore the clinical value of real-time triplane automated function imaging (AFI) in evaluating left ventricular long-axis systolic function of uremic patients before and after hemodialysis. Methods Totally 30 uremic patients (uremic group) and 32 healthy volunteers (control group) were enrolled. The patients received echocardiography before the first hemodialysis and 1 and 3 months after hemodialysis. Regional long-axis peak systolic strain (RLS) and global long-axis peak systolic strain (GLS) were measured with real-time triplane AFI. The indexes of the M-mode echocardiography and AFI were compared between uremic group and control group, and the correlation of GLS with left ventricular mass index (LVMI) and left ventricular ejection fraction (LVEF) were analyzed. Results In uremic group, GLS and RLS of all the segments before hemodialysis and 1 month after hemodialysis, GLS and RLS of some segments 3 months after hemodialysis were significant lower than those in control group (all P<0.05). In uremic group, GLS and RLS of some segments were significantly improved 1 and 3 months after hemodialysis compared with pre-hemodialysis (all P<0.05), of some segments were further improved 3 months after hemodialysis compared with 1 month after hemodialysis (all P<0.05). GLS was negatively correlated with LVMI (r=-0.547, P<0.01) and positively correlated with LVEF (r=0.252, P<0.01). Conclusion Real-time triplane AFI can early evaluate long-axis systolic function of left ventricular in patients with uremia.