【摘要】 目的应用应变率成像(SRI)技术评价单次血液透析对尿毒症患者左心房功能的影响。方法 31例既往无心血管病史的尿毒症患者,分别于透析前、后1 h行超声心动图检查。测量左房最大长径、横径并计算左房最大容积;脉冲多普勒测量二尖瓣口血流峰值速度E峰、A峰,并计算E/A;脉冲组织多普勒(PW-TDI)测量二尖瓣环舒张早期峰值速度(Ea)、舒张晚期峰值速度(Aa),并计算Ea/Aa;应变率成像分别测量房间隔、左房侧壁、前壁及下壁的心室收缩期左房峰值应变率(SRs)、心室舒张早期左房峰值应变率(SRe)、心房收缩期左房峰值应变率(SRa),并计算4个位点的平均值。结果尿毒症患者透析后与透析前相比,二尖瓣口血流频谱E峰降低(P<0.01),A峰差异无统计学意义(P>0.05),E/A下降(P<0.01);二尖瓣环PW-TDI指标:Ea降低(P<0.05),Aa差异无统计学意义(P>0.05),Ea/Aa下降(P<0.01);左房壁SRI指标:SRa升高(P<0.01),SRs,SRe差异无统计学意义(P>0.05)。结论应变率不受前负荷的影响,与脉冲多普勒血流成像、脉冲组织多普勒技术相比,能更准确评价透析对尿毒症患者左心房功能的影响。更多还原

【Abstract】 Objective To evaluate the changes of the left atrial function in patients with uremia before and after hemodialysis by strain rate imaging(SRI).Methods 31 patients with uremia without heart disease history were studied by echocardiography within one hour before and after hemodialysis.The biggest volume of LA were measured by Two-dimensional echocardiography;The peak E velocity(E),the peak A velocity(A)and E/A were measured by doppler echocardiography;The peak Ea velocity(Ea),the peak Aa velocity(Aa),and Ea/Aa were measured by doppler tissue imaging;Strain rate imaging(SRs,SRe and SRa)were performed at left atrial of each walls(anterior,inferior, lateral and septal).Results Compared with before hemodialysis,E,E/A ratio,Ea and Ea/Aa ratio decreased after hemodialysis (P<0.05),while A and Aa were not significantly different(P>0.05).Left atrium SRI index:SRa increased after hemodialysis(P<0.01),but SRs,SRe were not significantly different(P>0.05).Conclusions Strain rate imaging is not affected by preload reduction and can evaluate the changes of the left atrial function before and after hemodialysis more accurately.更多还原