【摘要】：目的 通過應(yīng)變率成像技術(shù)(SRI)評(píng)價(jià)處于腎功能衰竭階段患者的左心房功能。 方法 自2012年2月自2014年2月，選擇腎功能衰竭患者50例，正常對(duì)照20例進(jìn)行超聲心動(dòng)圖檢查。首先連接心電圖，同步屏幕顯示心電波形后，在二維模式下左室長軸切面測量收縮期左心房(LA)內(nèi)徑。于心尖切面采集四腔心三個(gè)心動(dòng)周期圖像存入儀器內(nèi)，啟動(dòng)TDI模式，采集心尖四腔心、二腔心、三腔心各三個(gè)心動(dòng)周期動(dòng)態(tài)圖像保存以備脫機(jī)分析。脫機(jī)分析，采用simpson法，測量左心房最大容積（LAmax），最小容積（LAmin），收縮前容積（Pla）以及左心房功能（left atriumejection fraction）LAEF，進(jìn)入儀器自帶Q-lab分析軟件，取樣容積設(shè)置0.2x0.4cm，取樣位置設(shè)定于左心十字交叉上方1.0cm處，測量左心房房間隔、側(cè)壁、前壁、下壁、后壁共5個(gè)位點(diǎn)應(yīng)變率（SR），測量應(yīng)變SRe、SRa、SRs峰值速度，記錄。 結(jié)果 1、常規(guī)超聲心動(dòng)圖：腎功能衰竭組左房容積增大明顯，大部分（50例中43例，占86%）患者左房收縮功能LAEF≥50%，只有（7例，占14%）少部分患者左房功能LAEF50%。 2、應(yīng)變率成像：腎功能衰竭組與對(duì)照組比較，腎功能衰竭組應(yīng)變率峰值SRe和SRs較對(duì)照組顯著減低（P0.01），說明心房的管道功能及儲(chǔ)存器功能受損，而兩組應(yīng)變率峰值SRa無顯著差異（P0.05），說明腎功能衰竭組左房泵功能未受影響。 3、腎衰竭組應(yīng)變率SRe/a1，而對(duì)照組SRe/a1，以下壁、前壁、后壁顯著（P0.01） 4、腎功能衰竭組內(nèi)，按50歲分界，兩組應(yīng)變率SRe，SRa，SRs均無顯著差異（P0.05） 結(jié)論 腎功能衰竭可導(dǎo)致左心房功能異常，包括管道功能、儲(chǔ)存器功能； SR能準(zhǔn)確、快速定量檢測腎功能衰竭患者左房的局部心肌的應(yīng)變率變化，通過應(yīng)變率各項(xiàng)指標(biāo)評(píng)價(jià)心房功能，，為臨床治療提供重要依據(jù)。
[Abstract]:Objective to evaluate left atrial function in patients with renal failure by strain rate imaging (SRI). Methods from February 2012 to February 2014, 50 patients with renal failure and 20 normal controls were examined by echocardiography. The left ventricular long axis section was used to measure the (LA) diameter of the left atrium in two dimensional mode. The images of three cardiac cycles of four cavities were collected on the apical section and stored in the instrument, and the TDI mode was started, and the dynamic images of the apical four cavities, two cavities and three cavities were collected for off-line analysis. Off-line analysis, simpson method was used to measure the maximum volume of left atrium (LAmax), the minimum volume of (LAmin), (pre-systolic volume (Pla) and the left atrial function (left atriumejection fraction) LAEF, (left atriumejection fraction) LAEF,) into the Q-lab analysis software. The sampling volume was set at 0.2 x 0.4 cm, and the sampling position was set at 1.0cm above the cross of the left atrium. The left atrial septum, lateral wall, anterior wall, inferior wall and posterior wall were measured by strain rate (SR),. Results 1. Conventional echocardiography showed that left atrial volume was significantly increased in renal failure group. Left atrial systolic function (LAEF) was more than 50 in most of the patients (43 out of 50 cases, 86%), only 7 cases (7 cases). Strain rate imaging: peak strain rate SRe and SRs in renal failure group were significantly lower than those in control group (P0.01), which indicated that atrial conduit function and storage function were impaired. However, there was no significant difference in peak strain rate SRa between the two groups (P0.05), indicating that left atrial pump function was not affected in renal failure group. There was no significant difference in SRS between the two groups according to the age limit of 50 years (P0.05). Conclusion Renal failure can lead to abnormal left atrial function, including conduit function and storage function, SR can be accurate. The changes of local myocardial strain rate of left atrium in patients with renal failure were measured quickly and quantitatively. The evaluation of atrial function by various indexes of strain rate provided important basis for clinical treatment.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R692.5

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