斑点追踪成像评慢性肾衰竭患者肾移植前后右心功能变化的研究
Assessment of Right Heart Function Changes after Kidney Transplantation by Speckle Tracking Imaging in Patients with Chronic Renal Failure
摘要: 目的：应用三维超声心动图(3DE)及斑点追踪成像(STI)评价慢性肾衰竭患者右心室功能及其肾移植前后的改变。方法：将46例慢性肾衰竭患者，分为未透析组(23例)及透析组(23例)，20例慢性肾衰竭患者行肾移植手术。对照组为23例健康志愿者。进行3DE和STI检查，获得右心室三维参数：右心室舒张末期容积(RVEDV)、右心室收缩末期容积(RVESV)、右心室射血分数(RVEF)及右心室游离壁纵向应变(RVFWLS)、右心室整体纵向应变(RVGLS)，分析上述参数在不同分组的变化。结果：未透析组RVFWL、SRVGLS的绝对值较透析组增大，RVEDV、RVESV、RVESVi较透析组减小(P < 0.05)。肾移植术后RVFWL、SRVGLS的绝对值较术前增大，RVEDV、RVESV、RVEDVi、RVESVi较术前减小(P < 0.05)。结论：3DE及STI能对肾移植术后患者右心室功能进行定量评估，协助临床改善患者远期预后。
Abstract: Objective: To assess right ventricular function and its changes after kidney transplantation in chronic renal failure patients subjected using three-dimensional echocardiography (3DE) and speckle tracking imaging (STI). Method: A total of 46 patients with chronic renal failure were divided into non dialysis group (23 cases) and dialysis group (23 cases), with 20 patients undergoing kidney transplantation surgery. There were 23 healthy volunteers in the control group. Perform 3DE and STI examinations to obtain three-dimensional parameters of the right ventricle: right ventricular end diastolic volume (RVEDV), right ventricular end systolic volume (RVESV), right ventricular ejection fraction (RVEF), right ventricular free wall longitudinal strain (RVFWLS), and right ventricular global longitudinal strain (RVGLS). The differences of the parameters among these groups were compared and analyzed. Result: The absolute values of RVFWL and SRVGLS in the non-dialysis group increased compared to the dialysis group, while RVEDV, RVESV, and RVESVi decreased compared to the dialysis group (P < 0.05). After kidney transplantation, the absolute values of RVFWL and SRVGLS increased compared to preoperative levels, while RVEDV, RVESV, and RVESVi decreased compared to preoperative levels (P < 0.05). Conclusion: 3DE and STI provide quantitative evaluation of right ventricular function post-kidney transplantation and contribute to improving the long-term clinical prognosis of patients.
文章引用：赵思佳, 宋晓霞, 周青, 田雨, 姜志荣. 斑点追踪成像评慢性肾衰竭患者肾移植前后右心功能变化的研究[J]. 临床医学进展, 2025, 15(5): 1680-1687. https://doi.org/10.12677/acm.2025.1551543

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