摘要
目的 探讨三维超声心动图技术评估维持性血液透析患者左心房功能的应用价值.方法 回顾性选择2022年3月至2023年1月杭州市中医院接受血液透析治疗的尿毒症患者45例,其中,23例左心房最大容积指数(LAVImax)增大(ELA组,LAVImax>34mL/m2)和22例LAVImax正常(NLA组,LAVImax≤34 mL/m2).另择同期本院41名健康体检者为对照组.采用4D Auto LAQ技术计算左心房最大容积(LAVmax)、左心房排空容积(LAEV)、左心房收缩前容积(LAVpre)、左心房最小容积(LAVmin)、左心房射血分数(LAEF)、左心房储备期纵向应变(LASr)、左心房管道期纵向应变(LAScd)、左心房储备期圆周应变(LASr-c)、左心房管道期圆周应变(LAScd-c)、左心房收缩期纵向应变(LASct)及左心房收缩期圆周应变(LASct-c).结果 3 组对象 LAVmax、LAEV、LAVpre、LAVmin、LAEF、LASr、LAScd、LASr-c、LAScd-c、LASct、LASct-c 比较,差异均有统计学意义(均P<0.01).ELA组、NLA组LAVmax、LAEV、LAVpre、LAVmin高于对照组,ELA组上述指标高于NLA组,ELA组、NLA组LAEF、LASr、LAScd、LASr-c、LAScd-c 低于对照组,ELA 组上述指标低于 NLA 组,ELA 组 LASct、LASct-c 低于对照组、NLA组,差异均有统计学意义(均P<0.01).结论 三维超声心动图可用于评估维持性血液透析患者左心房功能.
Abstract
Objective To explore the clinical application value of three-dimensional echocardiography in evaluating left atrial(LA)function in maintenance hemodialysis patients.Methods Forty-five patients on maintenance hemo-dialysis in Hangzhou Hospital of Traditional Chinese Medicine from March 2022 to January 2023 were enrolled.Among them,23 cases had enlarged LA with maximum volume index>34 mL/m2(ELA group)and 22 cases had normal LA with maximum volume index ≤34 mL/m2(NLA group).Forty-one healthy individuals underwent physical examination were selected as a control group.LA maximum volume(LAVmax),LA emptying volume(LAEV),LA volume before atrial contraction(LAVpre),LA minimum volume(LAVmin),LA ejection fraction(LAEF),LA reservoir longiludinal strian(LASr),LA conduit longiludinal strian(LAScd),LA reservoir circumferential strain(LASr-c),LA conduit circumferential strain(LAScd-c),LA contraction longiludinal strian(LASct)and LA contraction circumferential strain(LASct-c)were calculated using 4D Auto LAQ package.Results There were significant differences in LAVmax,LAEV,LAVpre,LAVmin,LAEF,LASr,LAScd,LASr-c,LAScd-c,LASct,and LASct-c among the three groups(all P<0.01).LAVmax,LAEV,LAVpre,and LAVmin were significantly higher in ELA group and NLA group than in the control group,and in ELA group than in NLA group(all P<0.01).LAEF,LASr,LAScd,LASr-c and LAScd-c were significantly lower in ELA group and NLA group than in the control group,and in ELA group than in NLA group(all P<0.01).LASct and LASct-c in ELA group were significantly lower than those in the control group and NLA group(all P<0.01).Conclusion Three-dimensional echocardiography can be used to evaluate LA function in main-tenance hemodialysis patients.