摘要
目的采用实时三维超声心动图(real-time three-dimensional echocardiography,RT-3DE)与右心室自动应变定量技术(autostrain right ventricle,Autostrain RV)分析其应用于慢性肾功能不全(chronic kidney disease,CKD)患者右心室功能评估的临床意义。方法选取2024年12月至2025年7月锦州医科大学附属第一医院126例CKD患者作为研究对象,依病情分为CKD1组(1~3期,轻中度,n=75)与CKD2组(4~5期,重度,n=51)。另纳入46名健康志愿者为对照组,对所有受试者行常规超声测量,并采用Autostrain RV及RT-3DE技术完成检查,比较三组受试者的右室功能参数。结果与对照组比较,CKD1组患者的右心室整体长轴应变(right ventricular global longitudinal strain,RVGLS)、右心室游离壁整体纵向应变(right ventricular free wall longitudinal strain,RVFWSL)及右心室射血分数(right ventricular ejection fraction,RVEF)显著降低,CKD2组患者的RVFWSL、右心室游离壁基底部纵向应变(longitudinal strain of the basal segment of right ventricular free wall,B-RVFWSL)、右心室游离壁中部纵向应变(longitudinal strain of the mid segment of right ventricular free wall,M-RVFWSL)、右心室游离壁心尖部纵向应变(longitudinal strain of the apical segment of right ventricular free wall,A-RVFWSL)、RVGLS、RVEF降低,右心室收缩末期容积指数(right ventricular end systolic volume index,RVESVI)增高。与CKD1组比较,CKD2组患者的RVFWSL、RVGLS、B-RVFWSL、RVEF水平下降,RVESVI水平上升,差异均有统计学意义(P<0.05)。右室功能参数与估算肾小球滤过率、血肌酐、尿素、胱抑素C相关性较好。受试者操作特征曲线分析表明,RVFWSL与RVEF联合诊断效能更高。结论RT-3DE联合Autostrain RV技术可于早期发现CKD患者右室功能的恶化,对病情评估、早期治疗和预后具有重要参考价值。
Objective To evaluate clinical significance of real-time three-dimensional echocardiography(RT-3DE)and autostrain right ventricle(Autostrain RV)quantification in evaluating right ventricular function in patients with chronic kidney disease(CKD).Methods A total of 126 patients with chronic kidney disease(CKD)at the First Affiliated Hospital of Jinzhou Medical University,enrolled from December 2024 to July 2025,were selected as study subjects.These patients were classified into CKD1 group(stages 1-3,mild to moderate,n=75)and CKD2 group(stages 4-5,severe,n=75)based on disease severity.Additionally,46 healthy volunteers were included as control group.All subjects underwent routine ultrasonographic measurements and examinations using Autostrain RV and RT-3DE technologies.The right ventricular functional parameters of three groups were compared.Results Compared with control group,patients in CKD1 group exhibited significantly reduced right ventricular global longitudinal strain(RVGLS),right ventricular free wall longitudinal strain(RVFWSL),and right ventricular ejection fraction(RVEF).In CKD2 group,RVFWSL,longitudinal strain of the basal segment of right ventricular free wall(B-RVFWSL),longitudinal strain of the mid segment of right ventricular free wall(M-RVFWSL),and longitudinal strain of the apical segment of right ventricular free wall(A-RVFWSL)were significantly decreased.The right ventricular function parameters(RVFWSL),RVGLS,and RVEF decreased,while the right ventricular end systolic volume index(RVESVI)increased.Compared with CKD1 group,the there were statistically significant reductions in RVFWSL,RVGLS,B-RVFWSL,and RVEF,as well as an increase in RVESVI in CKD group(P<0.05).The right ventricular function parameters showed strong correlations with estimated glomerular filtration rate,serum creatinine,blood urea,and cystatin C.Receiver operating characteristic(ROC)curve analysis demonstrated that the combined diagnostic efficacy of RVFWSL and RVEF was superior Conclusion RT-3DE combined with Autostrain RV technology enables early detection of right ventricular dysfunction in CKD patients,providing significant reference value for disease assessment,early intervention,and prognosis.
作者
郭馨瑶
张宝玲
朱颖君
马宇轩
高静
GUO Xinyao;ZHANG Baoling;ZHU Yingjun;MA Yuxuan;GAO Jing(Department of Ultrasound Medicine,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121001,Liaoning,China;Jinzhou Medical University,Jinzhou 121001,Liaoning,China)
出处
《中国现代医生》
2026年第5期28-33,共6页
China Modern Doctor
基金
锦州医科大学大学生创新创业训练计划项目(X202410160090)。
