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目的通过实时三维超声心动图(RT-3DE)评估早期慢性肾脏病(CKD)患者左心室收缩同步性。方法根据肾小球滤过率(GRF)将40例慢性肾脏病患者分为两组,分别为CKD1-2期组20例和CKD3-5期组20例,另随机选取20例体检正常人群作为对照组,先分别对3组行常规超声心动图一般参数的测量,然后再运用RT-3DE技术对每组左室收缩同步性的相应参数和时间-曲线变化进行分析评估。结果 (1)常规超声心动图:与对照组相比,CKD1-2期组舒张末期室间隔厚度(IVSTd)增加,差异有统计学意义(P<0.05),左室后壁厚度(LVPWd)比较差异无统计学意义(P>0.05)。CKD3-5期组IVSTd、LVPWd明显高于对照组(P<0.01);三组间的左室射血分数的差异无统计学意义(P>0.05)。(2)RT-3DE:CKD1-2期17节段容积-时间曲线较正常组有变化,走形高低不一,部分测量参数(Tmsv-6SD/R-R、Tmsv-16Dif/R-R、Tmsv-6Dif/R-R)较正常对照组增高,差异有统计学意义(P<0.05);CKD 3-5期组曲线变化更为显著且大部分参数均明显高于对照组(P<0.01)。结论 CKD早期患者的左室收缩同步性已发生改变,可通过RT-3DE技术进行评估。
Objective To assess the systolic left ventricular systolic function in patients with early chronic kidney disease (CKD) by real-time three-dimensional echocardiography (RT-3DE). Methods According to glomerular filtration rate (GRF), 40 patients with chronic kidney disease were divided into two groups: 20 cases in CKD1-2 group and 20 cases in CKD3-5 group, and 20 cases in normal control group In the control group, the general parameters of routine echocardiography were measured in three groups. Then the corresponding parameters and the time-curve changes of left ventricular systolic synchrony were analyzed by RT-3DE technique. Results (1) Conventional echocardiography: Compared with the control group, the end-diastolic interventricular septum thickness (IVSTd) increased in CKD1-2 group, the difference was statistically significant (P <0.05), left ventricular posterior wall thickness (LVPWd) The difference was not statistically significant (P> 0.05). The levels of IVSTd and LVPWd in CKD3-5 group were significantly higher than those in control group (P <0.01). There was no significant difference in LV ejection fraction between the three groups (P> 0.05). (2) RT-3DE: The volume-time curve of segment 17 of CKD1-2 changed more than that of normal group, and the height of the curve was different. Some parameters (Tmsv-6SD / RR, Tmsv-16Dif / RR, Tmsv-6Dif / RR) was significantly higher than that of the normal control group (P <0.05). The curve of CKD stage 3-5 was more significant and most parameters were significantly higher than that of the control group (P <0.01). Conclusions Early systolic LV systolic synchrony has changed in early CKD patients and can be assessed by RT-3DE technique.