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目的探讨超声斑点追踪技术(STI)测定左室心内膜下、中层和心外膜下心肌收缩期纵向峰值应变(SSL)评价不同构型尿毒症患者左室收缩功能的价值。方法选取65例尿毒症患者,按照左室不同构型分为左室构型正常组(LVN组,35例)和左室肥厚组(LVH组,30例),40例健康志愿者(对照组)。常规心脏数据测量后,应用STI获取所有患者心尖位3个长轴切面心内膜下、中层和心外膜下心肌SSL。结果三组间患者心肌各层SSL均保持梯度特征,即心内膜下心肌>中层心肌>心外膜下心肌;与对照组比较,LVN组心内膜下心肌SSL减低有统计学意义(P<0.05),LVH组心内膜下、中层和心外膜下心肌SSL减低均有统计学意义(P<0.05)。与LVN组比较,LVH组心内膜下心肌SSL减低有统计学意义(P<0.05)。结论不同构型尿毒症患者左室心肌受累程度不同,STI可评价尿毒症患者左室心肌分层应变。
Objective To evaluate the value of left ventricular systolic left ventricular (LV) systolic function by left ventricular endocardial systolic longitudinal peak strain (SSL) measured by ultrasound speckle tracking (STI). Methods Sixty-five patients with uremia were divided into three groups according to different left ventricular configurations: normal left ventricular group (LVN group, 35 cases), left ventricular hypertrophy group (LVH group, 30 cases), 40 healthy volunteers ). After conventional heart data measurements, three major axial apical, subendocardial, subependymal myocardial SSLs of all patients were obtained using STI. Results The levels of SSL in all the three groups of patients maintained the gradient characteristics, that is, subendocardial> midmyocardial> epicardial myocardium. Compared with the control group, the SSL in the subintimal myocardium in LVN group was significantly decreased (P <0.05). The levels of SSL in the subendocardial, middle and epicardial myocardium of LVH group were significantly decreased (P <0.05). Compared with LVN group, the myocardial SSL in LVH group decreased significantly (P <0.05). Conclusion Different degrees of left ventricular myocardial involvement in patients with different configurations of uremia, STI can assess left ventricular myocardial stratification in patients with uremia.