摘要
目的采用常规超声心动图与超声斑点追踪技术(STI)探讨常规血液透析(HD)、高通量血液透析(HFHD)改善尿毒症患者左心室收缩及舒张功能的异同。方法回顾性分析2013年1月至2014年2月在济南军区总医院87例尿毒症患者资料,随机分为两组:常规血液透析组(HD组,50例),高通量血液透析组(HFHD组,37例)。分别于治疗前及治疗6个月后,应用常规超声检测两组患者的左心室射血分数(LVEF),二尖瓣E峰、A峰比值(E/A),STI检测左心室乳头肌水平各室壁收缩期峰值应变率(SRs)、舒张早期峰值应变率(SRe)、舒张晚期峰值应变率(SRa)的平均值(m SRs、m SRe、m SRa)。统计学处理采用非配对t检验。结果治疗6个月后,CHD组LVEF、E/A、m SRs、m SRe、m SRa、m SRe/m SRa分别为9.6±0.71、13.5±2.04、14.1±3.25、22.5±5.67、1.2±0.22、18.8±2.03;HFHD组分别为13.4±3.20、18.5±3.39、19.1±4.92、32.8±7.34、1.3±0.35、25.6±5.70。两组间比较,LVEF、E/A、m SRs、m SRe变化率的差异有统计学意义(P<0.05);两组组内比较,LVEF与E/A、m SRs与m SRe/m SRa以及LVEF与m SRs、E/A与m SRe/m SRa的变化率差异均有统计学意义(P<0.05)。结论血液透析对尿毒症患者左心室收缩功能改善程度低于舒张功能改善程度;HFHD较HD能更好的改善左心室收缩及舒张功能;STI是一种早期、敏感地评价尿毒症患者左心室功能变化的方法。
Objective To explore the similarities and differences of improving left ventricular systolic and diastolic function in patients with uremia by conventional hemodialysis（ HD） and high flux hemodialysis（ HFHD） with conventional echocardiography and speckle tracking imaging（ STI）. Methods A total of 87 cases of uremia patients in Jinan Military General Hospital from January 2013 to February 2014 were selected and randomly divided into 2 groups： the conventional hemodialysis group（ HD group,50 cases）and high flux hemodialysis group（ HFHD group,37 cases）. Conventional echocardiography were performed to detect left ventricular ejection fraction（ LVEF）,mitral E peak,A peak ratio（ E / A）,and the systolic peak strain rate（ SRs）,early diastolic peak strain rate（ SRe）,late diastolic peak strain rate（ SRa） of the ventricular wall in left ventricular papillary muscle level were measured by STI in 2 groups of patients before treatment and after 6 months of treatment respectively. The average values（ m SRs,m SRe,m SRa） of SRs,SRe and SRa were calculated. Unpaired Student t tests were used to compare normally distributed data. Results The change rates of LVEF,E / A,m SRs,m SRe between the two groups had statistical differences after 6 months of treatment（ P〈0. 05）. Within groups comparisons,the change rates between LVEF and E / A,m SRs and m SRe /m SRa,LVEF and m SRs,E / A and m SRe / m SRa were significant statistically（ P〈0. 05）. Conclusion The degree of improving left ventricular systolic function is lower than that of diastolic function by HD in uremia patients. HFHD is better than HD in improving left ventricular systolic and diastolic function. STI can evaluate the changes of left ventricular function in patients with uremia sensitively and early.
出处
《中华消化病与影像杂志（电子版）》
2016年第3期107-110,共4页
Chinese Journal of Digestion and Medical Imageology(Electronic Edition)
基金
山东省自然科学基金面上项目(ZR2013HM026)
