3D-STI评价两种血液透析方式对尿毒症患者左心室整体收缩功能的影响

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Abstract Objective To evaluate the effects of different hemodialysis methods on the overall systolic function of the left ventricle in patients with uremia by using 3D spot tracking technique (3D-STI). Methods Thirty-five uremic dialysis patients with stable condition in the People’s Hospital of China Three Gorges University from January 2019 to December 2020 were selected. Hemodialysis and hemofiltration were performed on the above patients according to different dialysis methods. Cardiac ultrasonography was performed once before dialysis and within 30 minutes after dialysis. Comparison of cardiac ultrasound parameters (left ventricular global peak systolic strain [LVGPSL], left ventricular global longitudinal strain [LVGLS], left ventricular global circumferential strain [LVGCS], left ventricular global area strain [LVGAS], left ventricular global radial strain [LVGRS], left ventricular ejection fraction [LVEF], left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume [LVESV]) and patient-related clinical and blood biochemical indicators. The correlation between the changes of serum β2-microglobulin (β2-MG) concentrations and the changes of 3D-STI in the two groups was analyzed. Results The measured values of left ventricular end-diastolic diameter, left atrium diamete, left ventricular volumes index in hemodialysis and hemofiltration after dialysis were significantly lower than those before dialysis, and the differences were statistically significant (P ＜ 0.05); however, there was no significant difference in Sm between the two methods before and after dialysis (P > 0.05). After a single dialysis, the measured values of LVGPSL, LVGLS, LVGCS, LVGAS, LVGRS, LVEDV, and LVESV in the hemodialysis methods were lower than those before dialysis, and the differences were highly statistically significant (P ＜ 0.01); there was no significant difference in LVEF before and after dialysis (P ＞ 0.05). After a single dialysis, the LVESV in the hemofiltration methods was significantly lower than that before dialysis, and the difference was statistically significant (P ＜ 0.05). The serum urea and serum creatinine after a single dialysis in the two methods were lower than those before dialysis, and the differences were statistically significant (P ＜ 0.01). In the hemodialysis methods, the serum β2-MG after dialysis was higher than that before dialysis, and the difference was highly statistically significant (P ＜ 0.01). The serum β2-MG in the hemofiltration methods after dialysis was lower than that before dialysis, and the difference was highly statistically significant (P ＜ 0.01). The changes of serum β2-MG concentration before and after dialysis in the hemofiltration methods were negatively correlated with LVGLS (r = -0.45, P ＜ 0.05). Conclusion Hemodialysis has a certain damage to the overall systolic function of the left ventricle, while hemofiltration has a protective effect on the overall systolic function of the left ventricle. The possible mechanism is through filtering out macromolecular substances.

Key words： Three-dimensional Spot tracking Echocardiography Uremia Hemodialysis Hemofiltration Left ventricular function

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	ZHANG Bingyi CHEN Xiaorong CHEN Hongmin WANG Ting CHEN Lu DONG Meng PING Jie

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ZHANG Bingyi CHEN Xiaorong CHEN Hongmin WANG Ting CHEN Lu DONG Meng PING Jie. Evaluate of the effect of two hemodialysis methods on the overall left ventricular systolic function in patients with uremia by three-dimensional speckle tracking technology#br#[J]. 中国医药导报, 2022, 19(10): 89-93.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I10/89

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