实时三维超声心动图评价尿毒症患者左室收缩同步性

目的 通过实时三维超声心动图（RT-3DE）技术评价左室射血分数（LVEF）正常的尿毒症患者的左室收缩同步性.方法 尿毒症患者60例（尿毒症组）,健康者50例（正常对照组）,应用RT-3DE分析两组左室特定节段到达最小收缩容积时间（Tmsv）的标准偏差和最大差值被标准化为心动周期的百分比（ Tmsv 16-SD%、Tmsv 12-SD%、Tmsv 6-SD%、Tmsv 16-Dif%、Tmsv 12-Dif%及Tmsv 6-Dif% ）.结果 60例尿毒症患者中左室向心性肥厚和偏心性肥厚患者的Tmsv 16-SD%、Tmsv 12-SD%、Tmsv 6-SD%、Tmsv 16-Dif%、Tmsv 12-Dif%及Tmsv 6-Dif% 与正常对照组比较差异有统计学意义（P〈0.05）;而左室构型正常和向心性重构者上述指标与正常对照组比较,差异无统计学意义（ P〉0.05）.结论 尿毒症患者左室同步性随左室重构的加重而下降,RT-3DE技术能发现尿毒症患者左室同步性变化,对明确尿毒症患者心肌损害进程有重要意义.

Assessment of left ventricular systolic synchronicity in uremia patients by real-time three-dimensional echocardiography

Objective To assess the systolic synchronicity of uremia patients with normal left ventricular ejection fraction（LVEF） by real-time three-dimensional echocardiography （RT-3DE）. Methods Sixty uremia patients and fifty healthy volunteers were enrolled in this study. The percentage of stand deviation of time to minimal systolic volume （Tmsv） and max deviation of left ventricular segments were analyzed by RT -3DE（ Tmsv 16 - SD%, Tmsv 12 - SD%, Tmsv 6 - SD%, Tmsv 16 - Dif%, Tmsv 12 - Dif% and Tmsv 6 - Dif% ）. Results There was significant difference of Tmsv 16 - SD% , Tmsv 12 - SD%, Tmsv 6 - SD%, Tmsv 16 - Dif%, Tmsv 12 - Dif% and Tmsv 6 - Dif% among concentric, eccentric LV hypertrophy group and control group（ P 〈 0.05 ）, while there was no significant difference of above parameters between normal left ventricular strcutre group, concentric remodeling group and control group （ P 〉 0.05）. Conclusion Systolic synchronicity is impaired in uremia patients with severe LV remodeling, which may be associated with the increased myocardial fibrosis. RT-3DE could recognize the left ventrieular dyssynchrony of uremia patients and provide additional value for understanding myocardial damage of uremia patients.