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目的应用血流向量成像(VFM)技术评价慢性肾功能不全(CRF)患者左室舒张功能。方法根据患者透析前血肌酐水平选取CRF患者70例为病例组,病例组分为两个亚组:肾衰期组(I组)33例,尿毒症期组(Ⅱ组)37例,另选取健康体检者40例为对照组(Ⅲ组)。比较三组患者左室涡量平均值及能量损耗平均值在舒张期不同时相的变化。利用PW/TDI同步模式获取E/e′(L)及E/e′(S),与涡量平均值及能量损耗平均值进行相关性分析。结果 (1)涡量平均值:仅在心房收缩期病例组较对照组增高(P<0.01),Ⅱ组较I组增高(P<0.05);(2)能量损耗平均值:在减慢充盈期及心房收缩期病例组高于对照组(P<0.01),Ⅱ组较I组增高(P<0.05);(3)在心房收缩期涡量平均值、能量损耗平均值与E/e′呈正相关(P<0.05)。结论 VFM技术能够对CRF患者早期左室舒张功能变化进行评价并提供量化指标。
Objective To evaluate left ventricular diastolic function in patients with chronic renal insufficiency (CRF) by using flow cytometry (VFM) technique. Methods Seventy patients with CRF were selected as the case group according to the level of serum creatinine before dialysis. The case group consisted of two subgroups: 33 cases in the renal failure group (group I) and 37 cases in the uremia group (group Ⅱ) Forty healthy subjects were control group (group Ⅲ). The changes of mean LV diastolic and mean energy loss at different diastolic phases were compared between the three groups. E / e ’(L) and E / e’ (S) were acquired using the PW / TDI synchronization model, and the correlations were analyzed with the mean value of vorticity and the average energy loss. Results (1) The mean value of vorticity was higher than that of the control group only in the cases of atrial systole (P <0.01), that of the group Ⅱ was higher than that of the I group (P <0.05); (2) (P <0.05). (3) In the atrial systolic phase, the mean value of vorticity, average value of energy loss and E / e ’were significantly higher than those in control group (P <0.05). Conclusion VFM can evaluate the early changes of left ventricular diastolic function in patients with CRF and provide quantitative indicators.