摘要
目的探讨组织瓣环运动位移(TMAD)定量评价慢性肾脏病(CKD)患者左心室收缩功能的应用价值。方法选取30例CKD患者(实验组),再同期选取35例健康体检者(对照组)。应用组织斑点追踪技术快速获取心尖四腔及两腔心切面二尖瓣环四个位点运动位移,同期获取左心室整体纵向应变(GLS)及左心室整体圆周应变(GCS);应用线性相关分析TMAD参数与左心室射血分数(LVEF)、GLS间关系;绘制ROC曲线预测TAMD各参数诊断CKD患者左心室收缩功能减低效能。结果与对照组比较,实验组二维超声指标IVST、PWT、LVMI增大,差异有统计学意义(P<0.05);TMAD各参数T-AP4sep、T-AP4lat、T-AP4mid、T-AP4mid%、T-AP2int、T-AP2ant、T-AP2mid、T-AP2mid%、mTAMDmid及mTMADmid%均减低,差异有统计学意义(P<0.05);实验组T-AP4mid、T-AP2mid、mTMADmid、mTMADMmid%与LVEF呈正相关(r=0.522,r=0.344,r=0.475,r=0.413,P<0.05),与GLS呈负相关(r=-0.584,r=-0.430,r=-0.558,r=-0.620,P<0.01);mTMADmid%对预测CKD患者左心室收缩功能减低表现最好,mTMADmid%(AUC,0.93,敏感度、特异度分别为87.0%、95.0%,截断值11.9%)。结论应用TMAD可以早期定量评价CKD患者左心室收缩功能,且可重复性好。
Objective To explore the clinical value of tissue motion annular displacement in quantitative evaluation of left ventricular systolic function in patients with chronic kidney disease.Methods 30 patients with CKD were collected according to the 2017 Guidelines for the Screening,Diagnosis and Prevention of chronic kidney disease in China,and 35 healthy subjects were selected as the control group.Four sites of mitral annular motion displacement from the apical four-chamber and twochamber view were obtained by two dimensional speckle tracking imaging,and the overall longitudinal strain and overall circumferential strain of the left ventricle were obtained simultaneously.Linear correlation was used to analyze the relationship between TMAD parameters and left ventricular ejection fraction and golbal longitudinal strain.ROC curve was drawn to predict the efficiency of TAMD parameters in diagnosing subclinical reduced left ventricular systolic function in patients with CKD.Results Compared with the control group,IVST,PWT and LVMI were increased in CKD group(P<0.05).The measured value of TAP4sep,T-AP4lat,T-AP4mid,T-AP4mid%,T-AP2int,T-AP2ant,T-AP2mid,T-AP2mid%,mTAMDmid and mTMADmid%decreased(P<0.05).T-AP4mid,mTMADmid and mTMADMmid% were positively correlated with LVEF(r=0.522,r=0.475,r=0.413,P<0.05)and T-AP4mid,T-AP2mid,mTMADmid and mTMADMmid% were negatively correlated with GLS(r=-0.584,r=-0.430,r=-0.558,r=-0.620,P<0.01).mTMADmid%(AUC,0.93),with sensitivity of 87%,specificity of 95%,and cut-off value of 11.9%was better for predicting reduced left ventricular systolic function in patients with CKD.Conclusion TMAD can quantitatively evaluate the left ventricular systolic function in patients with chronic kidney disease at an early stage with good repeatability.
作者
贾玄慧
朱媛
沈亚梅
亢春苗
JIA Xuanhui;ZHU Yuan;SHEN Yamei;KANG Chunmiao(Department of Ultrasound,Shanxi Provincial People's Hospital,Xian 710068,China)
出处
《医学影像学杂志》
2024年第1期18-22,共5页
Journal of Medical Imaging
基金
陕西省重点研发计划项目(编号:2022SF-505)。
关键词
慢性肾脏病
组织瓣环运动位移
左心室射血分数
超声检查
Chronic kidney disease
Tissue motion annular displacement
Left ventricular ejection fraction
Ultrasound
作者简介
贾玄慧(1986-),女,医学硕士,主治医师,主要从事心血管超声诊断工作;通信作者:亢春苗,E-mail:kangchunmiao5650@163.com。
