组织多普勒技术对肝硬化肾功能损害患者左心舒张功能障碍的评价..doc

组织多普勒技术对肝硬化肾功能损害患者左心舒张功能障碍的评价 【关键词】超声心动描记术、组织多普勒显像技术、肝硬化、左心舒张功能、肾功能损害 Abstract Evaluation of Tissue Doppler Imaging on left ventricular diastolic function of liver cirrhosis patients with impaired renal function Objective To assess the clinical value of Tissue Doppler Imaging in evaluating the left ventricular diastolic function of liver cirrhosis patients with impaired renal function. Methods Thirty-three liver cirrhosis patients with impaired renal function and twenty-two liver cirrhosis patients without renal injury were enrolled. Average left ventricular end systolic diameter (LVDS), left ventricular end-diastolic diameter (LVDD), interventricular septum thickness (IVST), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) of all patients were determined by 2D echocardiography. The early and late diastolic mitral annular velocities (Em and Am) were detected by Tissue Doppler Imaging, the ratio of Em/Am were analyzed. Results Comparing with cirrhosis patients without renal injury, patients with impaired renal function have increased incidence of ascites and levels of serum total bilirubin (TBLL), serum creatinine (P0.05). Comparing with patients without renal injury, myocardial segments in patients with repaired renal function had lower peak velocity of the early diastolic mitral annular velocity (Em), higher peak velocity of the late diastolic mitral annular velocity (Am) and decreased Em/Am ratio (P0.05). Conclusions Tissue Doppler imaging techniques are more useful and flexible noninvasive modalities for the early recognition of improvement in left ventricular diastolic dysfunction of patients with liver cirrhosis. Keywords Echocardiography, Tissue Doppler imaging, Liver cirrhosis, Left ventricular diastolic function, Renal damage 肝硬化机体血流动力学改变，彩色多普勒超声检查无创，准确性高可以定量或半定量的检测患者心功能的改变。肝硬化患者血液动力学发生明显改变，主要表现外周动脉血管扩张、外周血管阻力下降，不同程度的心脏收缩和舒张功能障碍。在肝硬化患者中左心室舒张功能障碍发生率30-50%，肝硬化伴肾功能不全时，左心室舒张功能减退常出现，并被认为是心肌受损的早期表现。组织多普勒是近年来许多心脏舒张功能研究