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目的应用血流向量成像(VFM)技术分析慢性肾功能不全(CRF)患者舒张期左室血流流场特征,探讨其在评价CRF患者左室舒张功能中的价值。方法 30例CRF者和32例健康成人行超声心动图检查,VFM成像模式下采集心尖三腔心切面彩色血流动态图像。应用DAS-RS1软件观察和对比分析左室腔舒张期血流变化。结果与正常组比较,CRF患者舒张期左室腔血流流场分布不均,涡流数目增多、形态不一、方向紊乱、强度增加。CRF组左室腔各节段舒张期峰值流速(DVmax)、峰值流量(Fd)、舒张期正向流量(DQ+)、舒张期总流量(DQtotal)增加,二尖瓣下方涡量(Vmax)、涡流面积(Vor.A)及循环(Circu)增加。CRF组基底段DQtotal与血肌酐(Scr)、血尿素氮(Bun)呈正相关,与肾小球滤过率(GFR)呈负相关,E/e′与基底段DVmax、Fd及二尖瓣后叶下方涡量(P-Vmax)呈正相关。结论 CRF患者左心室血流流场发生变化,尤以涡流变化显著,VFM技术为评价其左室腔内血流流场变化特征及左室舒张功能改变提供了一种新方法。
Objective To analyze the characteristics of diastolic LV flow field in patients with chronic renal insufficiency (CRF) by using flow cytometry (VFM) technique and to explore its value in assessing left ventricular diastolic function in patients with CRF. Methods Thirty patients with CRF and 32 healthy adults underwent echocardiography. VFM imaging mode was used to acquire apical three-chamber centroid color flow dynamic images. DAS-RS1 software was used to observe and compare left ventricular diastolic blood flow changes. Results Compared with the normal group, the distribution of left ventricular blood flow in diastolic phase of CRF was uneven, the number of eddy currents increased, the morphology was different, the direction was disordered and the intensity was increased. In the CRF group, the diastolic peak velocity (DVmax), peak flow (Fd), diastolic positive flow (DQ +), diastolic total flow (DQtotal) Eddy area (Vor.A) and circulation (Circu) increased. DQtotal in basal segment of CRF group was positively correlated with serum creatinine (Scr) and blood urea nitrogen (Bun) and negatively correlated with glomerular filtration rate (GFR). E / e ’ Leaf vortex (P-Vmax) was positively correlated. Conclusion The flow field of left ventricular blood flow changes in patients with CRF, especially in the changes of vortex. VFM provides a new method to evaluate the changes of left ventricular blood flow and the changes of left ventricular diastolic function.