【摘要】 目的探讨超声斑点追踪技术(STI)测定左室心内膜下、中层和心外膜下心肌收缩期纵向峰值应变(SSL)评价不同构型尿毒症患者左室收缩功能的价值。方法选取65例尿毒症患者,按照左室不同构型分为左室构型正常组(LVN组,35例)和左室肥厚组(LVH组,30例),40例健康志愿者(对照组)。常规心脏数据测量后,应用STI获取所有患者心尖位3个长轴切面心内膜下、中层和心外膜下心肌SSL。结果三组间患者心肌各层SSL均保持梯度特征,即心内膜下心肌>中层心肌>心外膜下心肌;与对照组比较,LVN组心内膜下心肌SSL减低有统计学意义(P<0.05),LVH组心内膜下、中层和心外膜下心肌SSL减低均有统计学意义(P<0.05)。与LVN组比较,LVH组心内膜下心肌SSL减低有统计学意义(P<0.05)。结论不同构型尿毒症患者左室心肌受累程度不同,STI可评价尿毒症患者左室心肌分层应变。更多还原

【Abstract】 Objective To investigate the value of speckle tracking imaging(STI)in evaluating the systolic function of left ventricular subendocardium,midmyocardium and subepicardium in patients with uremia of different configurations.Methods Sixty-five patients with uremia were devided according to different configurations of left ventricule including left ventricular normal group(LVN group,n=35)and left ventricular hypertrophy group(LVH group,n=30).Forty healthy volunteers were selected as controls.High frame rate two-dimensional images were recorded from the apical four-chamber view,two-chamber view and long-axis of the left ventricle during three consecutive cardiac cycles.Peak systolic longitudinal strain(SSL)was measured in subendocardium,midmyocardium,subepicardium.Results SSL of subendocardium was higher than that of midmyocardium,and midmyocardium was higher than that of subepicardium in three groups.Compared with the control group,SSL of subendocardium in LVN group and LVH group were significantly lower(P<0.05).There were significant difference in SSL of midmyocardium and subepicardium in both LVH group and control group(P<0.05).Compared with LVN group,SSL of subendocardium decreased in LVH group(P<0.05).Conclusions STI technique can sensitively reflect the change of left ventricular systolic function in patients with uremia,and provide a reference for clinical treatment.更多还原