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目的:应用斑点追踪成像技术(STI)中的心肌分层应变探讨其在评价尿毒症患者左室圆周收缩功能方面的价值。方法:选取78例确诊为尿毒症并行维持性血液透析的患者,根据左室构型情况分为左室构型正常组(LVN组,42例)和左室肥厚组(LVH组,36例),选择38例健康人作为对照组。先行常规数据测量,接着应用STI获取所有患者胸骨旁左室二尖瓣口、乳头肌及心尖水平心内膜下心肌、中层心肌和心外膜下心肌收缩期圆周应变(CS)。结果:与对照组和LVN组比较,LVH组IVSTd、LVPWTd、LAESd、E/A显著升高(均P<0.05)。LVN组、LVH组和对照组的CS均存在如下规律:即心内膜下心肌CS最大,心外膜下心肌CS最小;与对照组比较,LVN组3层心肌CS降低均无统计学意义;与对照组及LVN组比较,LVH组二尖瓣口及乳头肌水平心内膜下和中层心肌CS均显著降低(均P<0.05)。结论:心肌分层应变技术可以定量逐层评价尿毒症患者左室CS,为准确判断其心肌受累情况提供一种新的检查方法。
Objective: To investigate the value of myocardial stratification in the use of speckle tracking imaging (STI) in assessing left ventricular systolic function in uremic patients. Methods: According to the left ventricular configuration, 78 patients diagnosed as uremic concurrent maintenance hemodialysis were divided into normal LV group (n = 42) and LVH group (n = 36) , 38 healthy people were chosen as the control group. Conventional data measurements were performed prior to STI acquisition in all patients with left ventricular mitral valve slippage, papillary muscles and apical subendocardial, midmyocardial and epicardial myocardial systolic circumferential strain (CS). Results: The levels of IVSTd, LVPWTd, LAESd and E / A in LVH group were significantly higher than those in control group and LVN group (all P <0.05). CS in LVN group, LVH group and control group all had the following rules: CS in the subendocardium was the largest and CS in the epicardium was the smallest. Compared with the control group, CS in the LVN group was not significantly reduced; Compared with the control group and the LVN group, the mitral valve and papillary muscles in the LVH group were significantly lower than those in the subendocardium and the middle myocardium (all P <0.05). Conclusion: Stratified myocardial stratification technique can quantitatively and quantitatively evaluate the left ventricular CS in patients with uremia, providing a new method for accurately judging the myocardial involvement.