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目的:应用超声心动图评价慢性肾脏疾病(CKD)患者左室结构及功能改变,探讨不同程度CKD患者左室改变情况。方法:对CKD非透析患者39例(CKD2~3期组19例,CKD4~5期组20例)及对照组40例进行常规肾脏扫查及超声心动图检查,通过二维超声观察CKD患者肾脏形态结构、实质回声、皮髓质分界、血流信号改变;通过超声心动图获得左室结构参数:左房内径(LAD)、左室舒张末期内径(LVID),左室质量指数(LVMI)、左室相对室壁厚度(RWT);左室功能参数:左室射血分数(EF)、二尖瓣口舒张早期血流速度E峰、晚期A峰、E/A、舒张早期二尖瓣环运动速度Em,E/Em。结果:①CKD2~3期组19例患者中6例患者肾脏声像图有明显改变,CKD4~5期组中18例患者肾脏声像图有显著改变;②与正常组比较,CKD2~3期组LVM、RWT、LAD均显著增高,CKD4~5期组LVID、LVMI、E、A、E/Em增高,DTE、E/A、Em减低,与CKD2~3期组比较,CKD4~5期组LVM、RWT、LAD、LVID、LVMI、E、A、E/Em显著增加,DTE显著减低,E/A、Em无明显差异;③CKD2~3期组中有5例左室重构(26.3%),CKD4~5期组患者中有17例左室壁重构(85%)。结论:早中期CKD患者其肾脏结构二维超声改变不明显,而超声心动图能早期检测到CKD患者左室构型及左室舒张功的改变,为临床上该病治疗及心血管并发症的预防提供有价值的参考信息。
Objective: To evaluate the changes of left ventricular structure and function in patients with chronic kidney disease (CKD) by echocardiography and to investigate the changes of left ventricular (LV) in patients with different degrees of CKD. Methods: 39 CKD non-dialysis patients (CKD2 ~ 3 group of 19 cases, CKD4 ~ 5 group of 20 cases) and the control group of 40 cases of conventional renal and echocardiography examination by two-dimensional ultrasound CKD patients with kidney The left ventricle diameter (LAD), left ventricular end-diastolic diameter (LVID), left ventricular mass index (LVMI), left ventricular mass index Left ventricular relative wall thickness (RWT); left ventricular function parameters: left ventricular ejection fraction (EF), mitral early diastolic flow velocity E peak, late A peak, E / A, early diastolic mitral annulus Movement speed Em, E / Em. Results: (1) There were significant changes in the renal sonography in 6 of 19 patients with CKD stage 2 ~ 3, and significant changes of renal echocardiography in 18 of CKD stage 4 ~ 5 patients. (2) Compared with the normal control group, LVM, RWT and LAD were significantly increased in group CKD4-5, and LVID, LVMI, E, A and E / Em increased, DTE, E / A and Em decreased in CKD4-5 group (P <0.05) .③The left ventricular remodeling (RWT), LAD, LVID, LVMI, E, A and E / Em significantly increased, DTE decreased significantly, Seventeen patients with CKD stage 4-5 had left ventricular remodeling (85%). CONCLUSION: There is no significant difference in the two-dimensional ultrasound of renal structure between CKD patients and CKD patients. Echocardiography can detect left ventricular diastolic function and left ventricular diastolic dysfunction in CKD patients at early stage. It is clinically useful for the treatment of cardiovascular disease and cardiovascular complications Prevention provides valuable reference information.