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目的:探讨速度向量成像(VVI)技术检测慢性肾脏疾病(CKD)早期患者左心室舒缩功能早期变化的价值。方法:选取30例左心室正常构型CKD早期患者(A组)和30例向心性重构CKD早期患者(B组),以30名健康体检者为对照(C组)。常规超声测定左心室舒张末期内径(LVIDd)、室间隔厚径(IVST)、左心室后壁厚径(LVPWT)、左心室射血分数(LVEF)、二尖瓣口舒张期血流频谱E、A比值;VVI技术测定左心室长轴16节段收缩期峰值应变率(SSRMAX)、舒张早期、晚期峰值应变率(DSRMAX/e、DSRMAX/n),进行各组之间的参数比较。结果:3组间LVEF差异无统计学意义。B组的E/A值低于C组及A组(均P<0.05)。B组部分局部心肌节段SSRMAX及舒张早期DSRMAX/e低于A组和C组(均P<0.05);A组舒张早期部分局部心肌节段DSRMAX/e低于C组(P<0.05),而A、C两组SSRMAX各个节段心肌间无明显差异;3组间各节段心肌舒张晚期DSRMAX/n无统计学差异。结论:VVI技术可以定量评价左心室局部功能,尽早发现CKD早期患者节段心肌舒缩功能变化。
Objective: To investigate the value of velocity vector imaging (VVI) in detecting the early changes of left ventricular systolic and diastolic function in patients with early stage of chronic kidney disease (CKD). Methods: Thirty CHD patients with early normal left ventricular configuration (group A) and 30 patients with early congenital congenital CKD (group B) were enrolled. Thirty healthy subjects were selected as control group (group C). The left ventricular end diastolic diameter (LVIDd), interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular ejection fraction (LVEF), mitral diastolic flow spectrum E, A ratio. The peak systolic strain rate (SSRMAX), peak diastolic strain rate (DSRMAX / e, DSRMAX / n) of 16 segments of long axis of left ventricle were measured by VVI technique, and the parameters of each group were compared. Results: There was no significant difference in LVEF between the three groups. The E / A value of group B was lower than that of group C and group A (both P <0.05). The SSRMAX and DSRMAX / e in partial myocardial segments in group B were lower than those in groups A and C (all P <0.05). In group A, the local diastolic DSRMAX / e in early diastolic phase was lower than that in group C (P <0.05) There was no significant difference between the segments of SSRMAX in groups A and C; there was no significant difference in DSRMAX / n between the three groups. Conclusion: The VVI technique can quantitatively evaluate the local function of left ventricle and find out the change of myocardial systolic and diastolic function in early stage of CKD.