[1]史文荣,张彩云,张国锐,等.三维斑点追踪技术评价老年肾源性继发性甲状旁腺功能亢进患者左心室收缩功能的研究[J].医学信息,2021,34(20):81-84.[doi:10.3969/j.issn.1006-1959.2021.20.020]
　SHI Wen-rong,ZHANG Cai-yun,ZHANG Guo-rui,et al.Evaluation of Left Ventricular Systolic Function with Maintenance Hemodialysis Complicated withSecondary Hyperparathyroidism Using Three-dimensional Speckle-tracking Imaging[J].Medical Information,2021,34(20):81-84.[doi:10.3969/j.issn.1006-1959.2021.20.020]
点击复制

三维斑点追踪技术评价老年肾源性继发性甲状旁腺功能亢进患者左心室收缩功能的研究()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年20期
页码:
81-84
栏目:
论著
出版日期:
2021-10-20

文章信息/Info

Title:
Evaluation of Left Ventricular Systolic Function with Maintenance Hemodialysis Complicated withSecondary Hyperparathyroidism Using Three-dimensional Speckle-tracking Imaging
文章编号:
1006-1959（2021）20-0081-04
作者:
史文荣1; 张彩云1; 张国锐2; 芦桂林1
石河子大学医学院第一附属医院超声医学科1，肾病科2，新疆 石河子 832008
Author(s):
SHI Wen-rong1; ZHANG Cai-yun1; ZHANG Guo-rui2; LU Gui-lin1
Department of Ultrasound1,Department of Nephrology2,the First Affiliated Hospital of Shihezi University School of Medicine,Shihezi 832008,Xinjiang,China
关键词:
三维斑点追踪成像; 维持性血液透析; 继发性甲状旁腺功能亢进; 左心收缩功能
Keywords:
Three-dimensional speckle-tracking imaging; Maintenance hemodialysis; Secondary hyperparathyroidism; Left ventricular systolic function
分类号:
R735.3
DOI:
10.3969/j.issn.1006-1959.2021.20.020
文献标志码:
A
摘要:
目的 应用三维斑点追踪成像（3D-STI）评价老年肾源性继发性甲状旁腺功能亢进（SHPT）患者的早期左心室收缩功能。方法 选取2019年6月-12月于我院治疗的60例老年维持性血液透析（MHD）患者60例，根据甲状旁腺激素（PTH）分为低水平PTH（L-PTH）组30例、正常水平PTH（N-PTH）组30例；另选取我院同期老年健康体检者30例为对照组。比较三组常规超声指标、左心室的整体纵向应变（GLS）、整体径向应变（GRS）、整体圆周应变（GCS）、整体面积应变（GAS），并对3D-STI应变参数与PTH进行相关性分析，3D-STI预测SHPT患者左室收缩功能受损的ROC曲线分析。结果 三组IVSd、LVPWd、LVEDd、LVEDs、LVEDV、LVESV、LVEF水平比较，差异无统计学意义（P＞0.05）；N-PTH组GLS、GCS、GRS、GAS低于对照组，L-PTH组GLS、GCS、GRS、GAS均低于N-PTH组和对照组，差异有统计学意义（P＜0.05）。PTH与GLS、GRS、GCS、GAS呈负相关（r=-0.692、-0.433、-0.463、-0.453，P＜0.05）；GLS、GRS、GCS、GAS预测SHPT患者左室收缩功能受损的曲线下面积分别为0.921、0.623、0.811、0.796，GLS诊断效能最大，GLS截断值为21.55%时，对应的敏感性为95.12%，特异性为69.13%，Youden指数为0.64。结论 3D-STI技术能够早期评估老年肾源性SHPT患者左心室整体收缩功能损伤情况。
Abstract:
Objective To evaluate the early left ventricular systolic function in elderly patients with renal secondary hyperparathyroidism (SHPT) using three-dimensional speckle-tracking imaging (3D-STI).Methods Sixty elderly patients with maintenance hemodialysis (MHD) who were treated in our hospital from June to December 2019 were selected. According to the level of parathyroid hormone (PTH), they were divided into low level PTH (L-PTH) group (30 cases) and normal level PTH (N-PTH) group (30 cases), another 30 cases of elderly health examination in our hospital were selected as the control group. The conventional ultrasound indexes, the global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), global area strain (GAS) of the left ventricle in the three groups were compared, and the correlation between 3D-STI strain parameters and PTH was analyzed. The ROC curve analysis of 3D-STI prediction of left ventricular systolic dysfunction in SHPT patients was performed.Results There was no significant difference in IVSd, LVPWd, LVEDd, LVEDs, LVEDV, LVESV and LVEF levels among the three groups (P>0.05); the GLS, GCS, GRS and GAS in the N-PTH group were lower than those in the control group, and the GLS, GCS, GRS and GAS in the L-PTH group were lower than those in the N-PTH group and the control group, and the difference was statistically significant (P<0.05). PTH was negatively correlated with GLS, GRS, GCS and GAS (r=-0.692, -0.433, -0.463, -0.453, P<0.05). The areas under the curve predicted by GLS, GRS, GCS and GAS for left ventricular systolic dysfunction in SHPT patients were 0.921, 0.623, 0.811 and 0.796, respectivel; the diagnostic efficacy of GLS was the highest. When the cutoff value of GLS was 21.55%, the corresponding sensitivity was 95.12%, the specificity was 69.13%, and the Youden index was 0.64.Conclusion 3D-STI can early evaluate left ventricular global systolic dysfunction in elderly patients with renal SHPT.

参考文献/References:

[1]Lekawanvijit S.Cardiotoxicity of uremic toxins:a driver of cardiorenal syndrome[J].Toxins(Basel),2018,10(9):352.[2]Morsy MS,Dishmon DA,Garg N,et al.Secondary Hyperparathyroidism in Heart Failure[J].Am J Med Sci,2017,354(4):335-338.[3]Onder H,Aydin I,Apaydin M.Ischemic stroke in the setting of secondary hyperparathyroidism due to vitamin D deficiency[J].J Neuroradiol,2018,45(6):391-393.[4]Yokoyama K,Fukagawa M,Shigematsu T,et al.A single-and multiple-dose, multicenter study of etelcalcetide in japanese hemodialysis patients with secondary hyperparathyroidism[J].Kidney Int Rep,2019,2(4):634-644.[5]Chen SC,Chen CF,Huang JC,et al.Link between peripheral artery disease and heart rate variability in hemodialysis patients[J].PLoS One,2015,10(8):e0120459.[6]Hruska KA,Sugatani T,Agapova O,et al.The chronic kidney disease-Mineral bone disorder (CKD-MBD):Advances in pathophysiology[J].Bone,2017,100(1):80-86.[7]Amzulescu MS,Langet H,Saloux E,et al.Improvements of Myocardial Deformation Assessment by Three-Dimensional Speckle-Tracking versus Two-Dimensional Speckle-Tracking Revealed by Cardiac Magnetic Resonance Tagging[J].J Am Soc Echocardiogr,2018,31(9):1021-1033.[8]Tamulenaite E,Zvirblyte R,Ereminiene R,et al.Changes of left and right ventricle mechanics and function in patients with end-stage renal disease undergoing haemodialysis[J].Medicina(Kaunas),2018,54(5):87.[9]Yang B,Lu C,Wu Q,et al.Parathyroid hormone, cardiovascular and all-cause mortality:A meta-analysis[J].Clin Chim Acta,2016,455(1):154-160.[10]Wu GY,Xu BD,Wu T,et al.Correlation between serum parathyroid hormone levels and coronary artery calcification in patients without renal failure[J].Biomed Rep,2016,5(5):601-606.[11]Truong VT,Phan HT,Pham KNP,et al.Normal Ranges of Left Ventricular Strain by Three-Dimensional Speckle-Tracking Echocardiography in Adults: A Systematic Review and Meta-Analysis[J].J Am Soc Echocardiog,2019,32(12):1586-1597.[12]周娟,朱文军,徐明民,等.三维斑点追踪成像技术评价慢性心力衰竭患者左心室收缩功能及收缩不同步性的价值[J].浙江医学,2016,38(17):1415-1418.[13]付甜,章蓉.三维斑点追踪技术评价慢性肾功能不全患者左室收缩功能及同步性的临床意义[J].临床合理用药杂志,2018,11(26):117-118.

相似文献/References:

[1]祁亚轩.不同血液净化方式对维持性血液透析患者残余肾功能影响的临床护理观察[J].医学信息,2018,31(01):167.[doi:10.3969/j.issn.1006-1959.2018.01.066]
　QI Ya-xuan.Clinical Nursing Observation on the Influence of Different Blood Purification Methods on Residual Renal Function in Maintenance Hemodialysis Patients[J].Medical Information,2018,31(20):167.[doi:10.3969/j.issn.1006-1959.2018.01.066]
[2]易丽华.运动疗法配合护理干预对维持性血液透析患者 营养状况及生活质量的影响[J].医学信息,2018,31(16):175.[doi:10.3969/j.issn.1006-1959.2018.16.056]
　YI Li-hua.Effect of Exercise Therapy Combined with Nursing Intervention on Nutritional Status and Quality of Life in Maintenance Hemodialysis Patients[J].Medical Information,2018,31(20):175.[doi:10.3969/j.issn.1006-1959.2018.16.056]
[3]刘 贝,郑 慧,周 旺,等.3D-STI联合心脏综合指数评价肺癌患者GP化疗方案的隐匿性心肌毒性[J].医学信息,2019,32(08):100.[doi:10.3969/j.issn.1006-1959.2019.08.029]
　LIU Bei,ZHENG Hui,ZHOU Wang,et al.Evaluation of Occult Myocardial Toxicity in GP Chemotherapy Regimen of Lung Cancer Patients by 3D-STI Combined with Cardiac Comprehensive Index[J].Medical Information,2019,32(20):100.[doi:10.3969/j.issn.1006-1959.2019.08.029]
[4]刘 艳.三段式康复教育模式在维持性血液透析患者中的应用效果[J].医学信息,2019,32(20):190.[doi:10.3969/j.issn.1006-1959.2019.20.062]
　LIU Yan.Application Effect of Three-stage Rehabilitation Education Mode in Maintenance Hemodialysis Patients[J].Medical Information,2019,32(20):190.[doi:10.3969/j.issn.1006-1959.2019.20.062]
[5]丘宝珍.碳酸镧治疗维持性血液透析患者高磷血症的疗效[J].医学信息,2019,32(24):148.[doi:10.3969/j.issn.1006-1959.2019.24.053]
　QIU Bao-zhen.Effect of Lanthanum Carbonate on Hyperphosphatemia in Patients with Maintenance Hemodialysis[J].Medical Information,2019,32(20):148.[doi:10.3969/j.issn.1006-1959.2019.24.053]
[6]陈爱梅.不同维持性血液透析效果的糖尿病肾病患者营养评估及个性化饮食护理[J].医学信息,2019,32(24):177.[doi:10.3969/j.issn.1006-1959.2019.24.066]
　CHEN Ai-mei.Evaluation of Nutritional Status and Personalized Diet Nursing for Diabetic Nephropathy Patientswith Different Maintenance Hemodialysis Effects[J].Medical Information,2019,32(20):177.[doi:10.3969/j.issn.1006-1959.2019.24.066]
[7]彭 金,肖三法,袁海花.血容量监测联合米多君治疗维持性血液透析低血压患者的临床研究[J].医学信息,2021,34(23):50.[doi:10.3969/j.issn.1006-1959.2021.23.014]
　PENG Jin,XIAO San-fa,YUAN Hai-hua.Clinical Study of Blood Volume Monitoring Combined with Midodrine in Patients with Maintenance Hemodialysis Hypotension[J].Medical Information,2021,34(20):50.[doi:10.3969/j.issn.1006-1959.2021.23.014]
[8]房 彩,孙蓓蓓,姚 博,等.KDQOL-SF量表评估社区血透中心维持性血液透析患者健康相关生活质量的意义[J].医学信息,2020,33(11):95.[doi:10.3969/j.issn.1006-1959.2020.11.027]
　FANG Cai,SUN Bei-bei,YAO Bo,et al.Significance of KDQOL-SF Scale to Evaluate the Health-related Quality of Life of Maintenance Hemodialysis Patients in Community Hemodialysis Centers[J].Medical Information,2020,33(20):95.[doi:10.3969/j.issn.1006-1959.2020.11.027]
[9]梁宏丽.基于Omaha系统的延续性护理模式对维持性血液透析患者行为依从性和钙磷代谢的影响[J].医学信息,2020,33(23):164.[doi:10.3969/j.issn.1006-1959.2020.23.048]
　LIANG Hong-li.Influence of Omaha System-based Continuous Nursing Model on Behavior Compliance and Calcium and Phosphorus Metabolism of Maintenance Hemodialysis Patients[J].Medical Information,2020,33(20):164.[doi:10.3969/j.issn.1006-1959.2020.23.048]
[10]王利芳,尹彬洁,郭佳玉,等.老年血液透析患者认知衰弱现状及其影响因素分析[J].医学信息,2021,34(03):142.[doi:10.3969/j.issn.1006-1959.2021.03.040]
　WANG Li-fang,YIN Bin-jie,GUO Jia-yu,et al.Analysis of the Current Status of Cognitive Weakness and Its Influencing Factors in Elderly Hemodialysis Patients[J].Medical Information,2021,34(20):142.[doi:10.3969/j.issn.1006-1959.2021.03.040]

更新日期/Last Update: 1900-01-01