【摘要】 目的探讨容量负荷变化对组织多普勒(TDI)与彩色M型多普勒(CMM)检测左心室舒张功能的影响。方法 88例肾功能衰竭患者按透析量分为三组:组1<2 000 ml,组2为2 000～3 000 ml,组3>3 000 ml,分别测定三组透析前后的舒张期二尖瓣口血流峰值速度(E、A);二尖瓣口血流推进速度(FPV);左室二尖瓣环平均收缩期峰值速度、舒张早期峰值速度和舒张晚期峰值速度(Mean Sa、Mean Ea、Mean Aa)。结果所有患者FPV值于透析后均明显下降;组1的TDI各参数透析后无显著改变,组2、组3患者透析后除Sa外各参数值则显著下降。结论评价左心室收缩功能正常的尿毒症透析患者的左心室舒张功能时,CMM测定的FPV值易受容量负荷影响,而TDI技术在透析量较少(<2 000 ml)时是一个稳定指标,但随透析量增大仍可受容量负荷的影响。二尖瓣环收缩期运动速度Sa则不依赖于容量负荷。更多还原

【Abstract】 Objective To explore the effects of the change of preload to the left ventricular diastolic,function by Tissue Doppler Imaging (TDI) and Colour M-mode Doppler (CMM).Methods 88 patients with uremia undergoing regular hemodialysis (H/D) were separated by the amount of body fluid removed during H/D procedure:group 1<2000ml,group 2 from 2000 ml to 3000 ml,group 3>3000ml.The diastolic trans-mitral velocity (E,A),early diastolic flow propagation velocity (FPV),the mean of mitral annulus systolic peak velocities,early diastolic peak velocities and later diastolic peak velocities of mitral annulus (Mean Sa、Mean Ea、Mean Aa) were obtained immediately before and after H/D.Results FPV of the three groups all significantly decreased after H/D.In group 1,the change of TDI parameters showed insignificant change.In group 2 and group 3,the change of all diastolic parameters showed stastistically significant difference except Mean Sa.Conclusions In uremic patients with normal left ventricular systolic function,it’s easy for FPV to be influenced by preloading.When the amount removed during H/D was less than 2000ml,the parameters of TDI was steady.When the amount removed during H/D was more than 2000ml, diastolic phase mitral annulus Doppler tissue velocities were not totally preload-independent.Systolic phase mitral an- nulus Doppler tissue velocity index (Sa) was independent.更多还原