CAJ | 학술논문

目的利用三维斑点追踪技术(3D-STE)评价尿毒症患者左心室心肌整体及节段纵向应变特征,并探讨其左室应变能力与透析时间的关系.方法将46例透析时间为0～5年的尿毒症患者,按不同透析时间段分为3组:A组17例,为透析时间≤1年的患者,平均年龄(53.00±12.63)岁；B组14例,为透析时间＞1～≤3年的患者,平均年龄(53.78±14.32)岁；C组15例,为透析时间＞3～≤5年的患者,平均年龄(52.16±10.43)岁；D组为正常对照组,50例,平均年龄(53.20±10.53)岁.在心尖四腔观,采用容积探头采集心脏全容积图像,并存储原始数据.运用TomTec 4D MV-Assessment软件进行脱机分析,获取左心室心肌整体及16节段收缩期纵向峰值应变测值及其均值.结果病例组组内各壁基底段至心尖段应变测值逐渐下降,而正常组各壁基底段至心尖段应变测值逐渐升高,但无论是正常组或病变组各组内这种由基底段至心尖段阶差式变化均无统计学差异.A、B、C组各个节段应变值均较对照组减低.A组与B组,A组与C组间各节段有明显差异,B组与C组间除前间隔基底段、中间段有差异外,其余节段无明显差异.A组、B组及C组整体应变与16节段应变值均值均较对照组减低,B、C组均较A组减低；B、C组间差异无统计学意义.结论 3D-STE能更好地评价尿毒症患者的左室收缩功能,透析治疗可能对尿毒症患者远期左心室收缩功能有一定保护作用.
목적 이용삼유반점추종기술(3D-STE)평개뇨독증환자좌심실심기정체급절단종향응변특정,병탐토기좌실응변능력여투석시간적관계.방법 장46례투석시간위0～5년적뇨독증환자,안불동투석시간단분위3조:A조17례,위투석시간≤1년적환자,평균년령(53.00±12.63)세；B조14례,위투석시간＞1～≤3년적환자,평균년령(53.78±14.32)세；C조15례,위투석시간＞3～≤5년적환자,평균년령(52.16±10.43)세；D조위정상대조조,50례,평균년령(53.20±10.53)세.재심첨사강관,채용용적탐두채집심장전용적도상,병존저원시수거.운용TomTec 4D MV-Assessment연건진행탈궤분석,획취좌심실심기정체급16절단수축기종향봉치응변측치급기균치.결과 병례조조내각벽기저단지심첨단응변측치축점하강,이정상조각벽기저단지심첨단응변측치축점승고,단무론시정상조혹병변조각조내저충유기저단지심첨단계차식변화균무통계학차이.A、B、C조각개절단응변치균교대조조감저.A조여B조,A조여C조간각절단유명현차이,B조여C조간제전간격기저단、중간단유차이외,기여절단무명현차이.A조、B조급C조정체응변여16절단응변치균치균교대조조감저,B、C조균교A조감저；B、C조간차이무통계학의의.결론 3D-STE능경호지평개뇨독증환자적좌실수축공능,투석치료가능대뇨독증환자원기좌심실수축공능유일정보호작용.
Objective To evaluate the characteristics of left ventricular systolic longitudinal strain in uremic patients and its relationship with dialysis time using three-dimensional speckle tracking echocardiography (3D-STE).Methods Forty-six uremic patients were divided into three groups according dialysis time (ranged 0-5 years):group A (≤1 year),group B (1 year＞time ≤3 years),group C (3 years ＞time≤5 years),group D was control group.The dynamic images of apical four chamber view were displayed and apical full-volume images were obtained and saved in all subjects using a full volume matrix probe.The original data was recorded and was analyzed by using off-line 3DT analysis software (TomTec 4D MV-Assessment).The longitudinal peak systolic strain and 16 segment systolic strains and strain mean value in 16 segment of left ventricular were acquired and compared.Results The peak strain of apical segment was lower than that of the basal segment and the middle segment and it had an increasing trend from the apical segment to the basal segment in three uremia groups.Instead,it had a decreasing trend from the apical segment to the basal segment in control group.But the differences were not statistically significant.The longitudinal peak systolic strain value,16 segment strain value and mean value of 16 segment strain all were lower in three uremic groups than those of control group.Every segment of 16 segment stain value in group A was higher than those of group B and C.There was no difference in every segment between B and C group in addition to basal and middle segment of anterior septum.Conclusions 3D-STE could evaluate the left ventricular systolic function in uremic patients and the cardiac function could be partly protected by regular dialysis treatment.