Objective To investigate the value of three-dimensional speckle tracking imaging (3D-STI) in evaluating the right ventricular ( RV) function of uremia patients undergoing peritoneal dialysis ( PD) . Methods Thirty-five uremia patients undergoing PD ( PD group) and 26 healthy subjects ( control group) were enrolled. Left ventricular end-diastolic inner diameter ( LVIDd) , left ventricular end-systolic inner diameter ( LVISd) , interventricular septum thickness ( IVSd) , left ventricular ejection fraction ( LVEF) , right ventricular diastolic inner diameter of the base ( basal RVd) , right ventric-ular fractional area change ( RVFAC) and pulmonary artery systolic pressure ( PASP) were recorded by conventional ultra-sound in the PD group and the control group before dialysis and 3-6 months after dialysis. The right ventricular global longi-tudinal peak systolic strain ( RVGLS) , right ventricular global circumferential peak systolic strain ( RVGCS) , right ventric-ular global radial peak systolic strain ( RVGRS) , right ventricular global area peak systolic strain ( RVGAS) , right ventric-ular end systolic volume ( RVESV) , right ventricular end diastolic volume ( RVEDV) and right ventricular ejection fraction (RVEF) were measured by 3D-STI. Results Conventional ultrasound measurements: compared with the control group, LVIDd, LVISd, IVSd and PASP increased in the PD group before dialysis (P<0. 05 or P<0. 01);LVEF and the volume of right ventricle had no significant changes (all P>0. 05); the above indexes of the PD group had no significant differ-ences before and after dialysis (all P>0. 05). Three-dimensional speckle tracking calculation results: compared with the control group, the absolute values of RVGLS, RVGAS, RVGCS and RVGRS decreased significantly before dialysis ( all P<0. 05), RVEDV and RVESV increased in the PD group (all P<0. 05), and we did not observed any significant differ-ence in RVEF (P>0. 05). In the PD group, RVEDV and RVESV decreased significantly (all P<0. 05), and the abso-lute value of RVGLS increased significantly as compared with those before dialysis (P<0. 05). Conclusions The appli-cation of 3D-STI can facilitate the early detection of decreased GLS, GRS, GCS, GAS and the increased EDV and ESV of the right ventricle in uremic patients when RVEF was normal. RVGLS can be used as an important parameter for right ven-tricular function improvement in uremic patients undergoing PD.%目的：探讨三维斑点追踪技术评价尿毒症腹膜透析患者右心室功能的价值。方法选取腹膜透析患者35例(透析组)及同期健康体检者26例(对照组)。采用常规二维超声测算对照组、透析组透析前和透析3~6个月(透析后)左心室舒张期末内径( LVIDd)、左心室收缩期末内径( LVISd)、室间隔厚度( IVSd)、左心室射血分数( LVEF)、舒张期右心室基底部内径( basal RVd)、右心室面积变化分数( RVFAC)和肺动脉收缩压( PASP)；三维斑点追踪成像技术测算右心室整体纵向收缩期峰值应变( RVGLS)、右心室整体圆周收缩期峰值应变( RVGCS)、右心室整体径向收缩期峰值应变( RVGRS )、右心室整体面积收缩期峰值应变( RVGAS )、右心室收缩期末容积( RVESV)、右心室舒张期末期容积( RVEDV)及右心室射血分数( RVEF)。结果常规二维超声测算结果：与对照组比较,透析组透析前LVIDd、LVISd、IVSd、PASP升高(P<0.05或<0.01),LVEF及右心室大小无明显变化(P均>0.05)；透析组透析前后比较,以上指标比较差异无统计学意义(P均>0.05)。三维斑点追踪成像技术测算结果：与对照组比较,透析组透析前RVGLS、RVGAS、RVGCS、RVGRS绝对值明显降低(P均<0.05),RVEDV、RVESV明显升高(P均<0.05),RVEF无明显变化(P>0.05)；与透析组透析前比较,透析后RVEDV、RVESV明显减小(P均<0.05),RVGLS绝对值明显升高(P<0.05)。结论应用三维斑点追踪成像技术可发现尿毒症患者在RVEF正常时就已经出现右心室RVGLS、RVGRS、RVGCS、RVGAS的显著降低,及RVEDV、RVESV的显著增大；RVGLS可作为尿毒症患者腹膜透析右心室功能早期改善的一项重要指标。
展开▼
