摘要
目的应用血流向量成像（VFM）技术分析尿毒症患者左心室舒张期血流动力学变化特征。方法选择尿毒症患者40例为病例组，另选择40例健康体检者为对照组，比较两组间左室心尖段、中间段、基底段的涡量、总能量损耗（sEL）、平均能量损耗（aEL）及循环在舒张期不同时相的变化。利用双多普勒同步取样技术获取E／e’，与涡量、sEL、aEL及循环进行相关性分析。结果①两组的涡量、sEL及aEL在等容舒张期仅心尖段差异有统计学意义，心房收缩期3个节段差异均有统计学意义（P〈0．05）；两组的二尖瓣前叶循环在快速充盈期及二尖瓣后叶循环在心房收缩期差异均有统计学意义[（15．94±8．40）m2／s对（8．36±7．84）m2／s，（5．34±5．24）m2／s对（13．37±10．42）m2／s，均P〈0．05]。②同一节段各时相以及同一时相各节段相比，两组的涡量、sEL及aEL差异均有统计学意义（P〈0．01）。③病例组在快速充盈期基底段（r=0．34，P=0．046）及心房收缩期基底段（r=0．38，P=0．02）的涡量与E／e’呈正相关，等容舒张期基底段、快速充盈期中间段及基底段的sEL与E／e’呈正相关（r1=0．44，P1=0．008；r2=0．48，P2=0．003；r3=0．50，P3=0．002），上述时相的aEL与E／e’亦呈正相关（r1=0．39，P1=0．017；r2=0．49，P2=0．002；r3=0．48，P3=0．003）。结论VFM技术可直观反映尿毒症患者左室舒张期血流动力学变化，涡量、能量损耗及循环与心脏舒张功能的评价指标相关。
Objective To assess the clinical application value of vector flow mapping （VFM） in evaluating the left ventricular diastolic function in patients with uremia. Methods Forty patients with uremia and forty healthy volunteers were enrolled. The quantitative parameters, including vorticity, sum total energy loss （sEL）, average energy loss（aEL）, and the alteration circulation were measured in the VFM imaging mode. Difference was evaluated between two groups at apical, mid and basal segments at different periods. E/e＇was derived via dual-Doppler imaging technology. And correlationship was analyzed between vorticity,sEL,aEL,circulation and E/e＇ ,separately. Results （1）At apex segment of isovolumetric relaxation time and at three segments of atrial systole, there were difference in vorticity, sEL, aEL between two groups （ P 〈0.05）. Circulation in rapid filling phase of anterior mitral valve and slow filling phase of posterior mitral valve were different[（15.94 ± 8.40）m2/s vs （8.36 ± 7.84）m2/s,（5.34 ± 5.24）m2/s vs （13.37 ± 10.42） m2/s, P 〈0.05]. （1） In control group, vorticity, sEL and aEL were different in different segments of same phase or at different phases of same segment, and also did in the uremia group（ P 〈0.01 ）. （2）In uremia group,vorticity had a good correlation with E/e＇at basal segment of rapid filling phase（ r = 0.34, P = 0.046）and atrial systole（ r = 0.38, P = 0.02）. And sEL had a good correlation with E/e＇at basal segment of rapid filling phase,isovolumetric relaxation time and at mid segment of rapid filling phase（r1 = 0.44, P1 = 0.008;r2 = 0.48,P2 = 0.003;r3 = 0.50,P3 = 0.002）,and in time phase mentioned above,there were also the correlationship between aEL and E/e＇ （ r1 = 0.39, P1 = 0.017 ; r2 = 0.49, P2 = 0.002 ; r3 = 0.48, P3 = 0.003 ）. Conclusions VFM can be utilized to analyze left ventricular hemodynamics features of uremia patients and it may be a good supplement for assessing cardiac diastolic function.
出处
《中华超声影像学杂志》
CSCD
北大核心
2015年第11期942-947,共6页
Chinese Journal of Ultrasonography
