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目的应用三维整体径向应变(GRS)评价早期慢性肾病(CKD)患者左心室心肌收缩功能。方法选取26例CKD 2期、20例CKD 3期患者及30例健康志愿者(对照组)。行常规二维超声心动图和三维斑点追踪成像(3D-STE),测量并比较常规超声心动图指标:室间隔舒张末期厚度(IVSTd)、左心室舒张末期内径(LVEDd)、舒张末期左室后壁厚度(LVPWTd)、舒张末期左心室容积(EDV)、收缩末期左心室容积(ESV)和3D-STE指标:左心室三维射血分(3D-LVEF)、三维左心室心肌质量指数(3D-LVMI)及左心室整体径向应变(GRS)差异。结果与对照组相比,CKD 2期的IVSTd增大,LVEDd、GRS减小;CKD 3期的IVSTd、LVESV、3D-LVMI显著增大,LVEDd、3D-LVEF、GRS显著减小;与CKD 2期相比,CKD 3期的IVSTd、3D-LVMI增大,LVEDd、GRS减小,以上差异均有统计学意义(P<0.05)。结论 CKD早期患者左心室心肌收缩功能已经减低,可通过GRS来评价。
Objective To evaluate left ventricular systolic function in patients with early chronic kidney disease (CKD) by using three-dimensional global radial strain (GRS). Methods Twenty - six patients with CKD stage 2, 20 patients with CKD stage 3 and 30 healthy volunteers (control group) were enrolled. Conventional two-dimensional echocardiography and three-dimensional speckle tracking imaging (3D-STE) were performed to measure and compare the conventional echocardiographic parameters: end-diastolic dimension (IVSTd), left ventricular end diastolic dimension (LVEDd), end-diastolic left ventricular LVPWTd, EDV, ESV and 3D-STE were measured by 3D-LVEF, 3D-LVVEF, LVMI) and left ventricular total radial strain (GRS). Results Compared with the control group, the IVSTd, the LVEDd and the GRS in the CKD stage 2 were increased. The levels of IVSTd, LVESV and 3D-LVMI in the CKD stage 3 were significantly increased, while the LVEDd, 3D-LVEF and GRS were significantly decreased. Compared with the control group, the levels of IVSTd, 3D-LVMI and LVEDd and GRS in CKD stage 3 were significantly decreased (all P <0.05). Conclusions Left ventricular systolic function has been reduced in early CKD patients and can be assessed by GRS.