标题：超声心动图评估维持性血液透析患者心脏结构及功能改变的价值

      作者：赖锦彬，陈美珊，汤小芳，倪惜芝    深圳市宝安区福永人民医院超声科，广东 深圳 518103

      卷次： 2023年34卷22期

      【摘要】 目的 探讨超声心动图评估维持性血液透析患者心脏结构及功能改变的价值。方法 回顾性分析2020年6月至2022年9月在深圳市宝安区福永人民医院诊治的64例维持性血液透析患者的临床资料(研究组)，另选择同期在本院体检的50例健康者作为对照组，所有入选者均经超声心动图评估。比较研究组患者治疗前与对照组及研究组患者治疗前后的左房内径(LAD)、左室后壁厚度(LVPWd)、左室舒张末期内径(LVIDd)、室间隔舒张期厚度(IVSD)、二尖瓣舒张晚期峰值流速(VA)、二尖瓣舒张早期峰值流速(VE)、二尖瓣舒张早期与舒张晚期峰值流速之比(E/A)、左室射血分数(LVEF)、左室质量指数(LVMI)、左室质量(LVM)等超声心动图指标。结果 治疗前，研究组患者的LAD、LVPWd、LVIDd、IVSD、VA、VE、LVMI、LVM水平分别为(40.03±6.57) mm、(11.79±1.82) mm、(53.16±6.17) mm、(12.62±2.20) mm、(104.36±28.64) cm/s、(97.08±30.87) cm/s、(150.46±43.62) g/m2、(271.03±84.08) g，明显高于对照组的(33.13±3.25) mm、(8.69±0.88) mm、(48.04±3.77) mm、(8.47±0.85) mm、(75.44±19.11) cm/s、(72.55±15.12) cm/s、(79.93±14.15) g/m2、(140.62±26.77) g，LVEF水平为(63.18±8.83)%，明显低于对照组的(66.05±5.60)%，差异均有统计学意义(P<0.05)，而两组受检者的E/A水平比较差异无统计学意义(P>0.05)；研究组患者治疗前后的LAD、LVPWd、LVIDd、IVSD、VA、VE、E/A、LVEF、LVM水平比较差异均无统计学意义(P>0.05)，但研究组患者治疗后的 LVMI水平为(134.96±43.78) g/m2，明显低于治疗前的(150.46±43.62) g/m2，差异有统计学意义(P<0.05)。结论 超声心动图能够有效评估维持性血液透析患者心脏结构及功能变化，具有较大的临床价值。
      【关键词】 慢性肾脏病；维持性血液透析；超声心动图；心脏结构；心脏功能
      【中图分类号】 R459.5 【文献标识码】 A 【文章编号】 1003—6350（2023）22—3297—04

Value of echocardiography in evaluating cardiac structural and functional changes in patients undergoingmaintenance hemodialysis.
LAI Jin-bin, CHEN Mei-shan, TANG Xiao-fang, NI Xi-zhi. Department of Ultrasound,Shenzhen Bao'an District Fuyong People's Hospital, Shenzhen 518103, Guangdong, CHINA
【Abstract】 Objective To explore the value of echocardiogram in evaluating cardiac structure and functionchanges in patients undergoing maintenance hemodialysis. Methods The clinical data of 64 patients undergoing main-tenance hemodialysis admitted to Shenzhen Bao'an District Fuyong People's Hospital from June 2020 to September 2022were retrospectively analyzed (study group), and 50 healthy individuals who underwent physical examination in the hos-pital during the same period were selected as the control group. All the enrolled subjects were evaluated by echocar-diography. Left atrial diameter (LAD), left ventricular posterior wall thickness (LVPWd), left ventricular internal diam-eter at end-diastole (LVIDd), interventricular septal thickness at diastole (IVSD), late diastolic peak flow velocity (VA)of mitral valve, early diastolic peak flow velocity (VE) of mitral valve, and E/A value, left ventricular ejection fraction(LVEF), left ventricular mass index (LVMI), left ventricular mass (LVM), and other echocardiographic were comparedbetween the study group and control group before and after treatment, and also in the study group before and after treat-ment. Results Before treatment, the LAD, LVPWd, LVIDd, IVSD, VA, VE, LVMI, and LVM levels in the studygroup were (40.03±6.57) mm, (11.79±1.82) mm, (53.16±6.17) mm, (12.62±2.20) mm, (104.36±28.64) cm/s, (97.08±30.87) cm/s, (150.46±43.62) g/m2, (271.03±84.08) g, which were significantly higher than (33.13±3.25) mm, (8.69±0.88) mm, (48.04±3.77) mm, (8.47±0.85) mm, (75.44±19.11) cm/s, (72.55±15.12) cm/s, (79.93±14.15) g/m2, (140.62±26.77) g in the control group; the LVEF level was (63.18±8.83)%, significantly lower than (66.05±5.60)% in the controlgroup; the differences were statistically significant (P<0.05). There was no significant difference in E/A level betweenthe two groups (P>0.05). There were no significant differences in LAD, LVPWd, LVIDd, IVSD, VA, VE, E/A, LVEF,and LVM levels before and after treatment in the study group (P>0.05). The LVMI level in the study group after treat-ment was (134.96 ±43.78) g/m2, which was significantly lower than (150.46 ±43.62) g/m2 before treatment (P<0.05).Conclusion Echocardiography can effectively evaluate the cardiac structure and function changes in patients undergo-ing maintenance hemodialysis, which has great clinical value.
      【Key words】 Chronic kidney disease; Maintenance hemodialysis; Echocardiography; Cardiac structure; Cardiacfunction