| 姬莉芹,肖为为,高雪,李厚钰,邹安灵子,张心茹,苗茁勐,于绍梅.左心房容积/机械耦合指数预测慢性肾脏病患者左心房功能受损[J].中国医学影像技术,2025,41(5):733~738 |
| 左心房容积/机械耦合指数预测慢性肾脏病患者左心房功能受损 |
| Left atrial volumetric/mechanical coupling index for predicting left atrial dysfunction in patients with chronic kidney disease |
| 投稿时间：2024-09-02 修订日期：2025-03-29 |
| DOI：10.13929/j.issn.1003-3289.2025.05.008 |
| 中文关键词: 肾病 超声心动描记术 心房功能,左 |
| 英文关键词:nephrosis echocardiography atrial function, left |
| 基金项目:贵州省科技计划项目(黔科合成果-LC[2024]092)。 |
| 作者 | 单位 | E-mail | | 姬莉芹 | 贵州医科大学附属医院超声医学科, 贵州 贵阳 550004
贵州医科大学医学影像学院, 贵州 贵阳 550004 | | | 肖为为 | 贵州医科大学附属医院超声医学科, 贵州 贵阳 550004
贵州医科大学医学影像学院, 贵州 贵阳 550004 | | | 高雪 | 贵州医科大学医学影像学院, 贵州 贵阳 550004 | | | 李厚钰 | 贵州医科大学附属医院超声医学科, 贵州 贵阳 550004
贵州医科大学医学影像学院, 贵州 贵阳 550004 | | | 邹安灵子 | 贵州医科大学附属医院超声医学科, 贵州 贵阳 550004
贵州医科大学医学影像学院, 贵州 贵阳 550004 | | | 张心茹 | 贵州医科大学医学影像学院, 贵州 贵阳 550004 | | | 苗茁勐 | 贵州医科大学医学影像学院, 贵州 贵阳 550004 | | | 于绍梅 | 贵州医科大学附属医院超声医学科, 贵州 贵阳 550004 | 18885117797@qq.com |
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| 中文摘要: |
| 目的 观察左心房容积/机械耦合指数(LACI)预测慢性肾脏病(CKD)患者左心房(LA)功能受损的价值。方法 回顾性收集213例CKD(CKD组)及50名健康人(对照组),比较组间临床资料、实验室指标及超声心动图参数;根据LACI四分位数值将CKD组分为4个亚组,对比亚组间临床、实验室指标及超声心动图参数,分析LACI与心肌损伤实验室标志物及超声心动图参数的相关性。以LAVI＞34 ml/m2为LA功能受损,评估LACI、LA应变及LA僵硬指数(LASI)预测CKD患者LA功能受损的效能。结果 组间性别、血压、肌酐、肾小球滤过率估计值(eGFR)、肌钙蛋白T(cTnT)、肌酸激酶同工酶(CK-MB)、N末端脑钠肽原(NT-proBNP)差异均有统计学意义(P均＜0.05)。随LACI升高,CKD组内各亚组血压和糖尿病患病率、cTnT及NT-proBNP水平均呈升高趋势而eGFR呈降低趋势。LACI与cTnT、CK-MB、NT-proBNP及多个超声心动图参数均相关(P均＜0.001)。以LACI预测CKD患者LA功能受损的AUC为0.884,高于LA储备期、管道期、收缩期应变及LASI(AUC=0.652、0.621、0.611、0.746,P均＜0.05)。结论 利用LACI可有效预测CKD患者LA功能受损。 |
| 英文摘要: |
| Objective To observe the value of left atrial volume/mechanical coupling index (LACI) for predicting left atrial (LA) dysfunction in patients with chronic kidney disease (CKD). Methods Totally 213 CKD patients (CKD group) and 50 healthy controls (control group) were enrolled. Clinical data, laboratory indicators and echocardiographic parameters were compared between groups. According to quartile values of LACI, patients in CKD group were further divided into 4 subgroups, and their clinical, laboratory indicators and echocardiographic parameters were compared. The correlations between LACI and laboratory markers of myocardial injury as well as echocardiographic parameters were analyzed. Taken LAVI＞34 ml/m2 as LA dysfunction, the efficacy of LACI, LA strain and LA stiffness index (LASI) for predicting LA dysfunction in CKD patients were evaluated. Results Statistical differences of gender, blood pressure, creatinine, estimated glomerular filtration rate (eGFR), cardia troponinT (cTnT), creatine kinase isoenzymes (CK-MB) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were found between groups (all P＜0.05). In CKD group, with the increase of LACI, the prevalence of blood pressure and diabetes, the levels of cTnT and NT-proBNP in different subgroups showed increasing trend, while eGFR showed a decreasing trend. LACI was correlated with cTnT, CK-MB, NT-proBNP and multiple echocardiographic parameters (all P＜0.001). The AUC of LACI for predicting LA dysfunction in CKD patients was 0.884, higher than that of LA strain during reservoir phase, conduit phase, contraction phase and LASI (AUC=0.652, 0.621, 0.611, 0.746, all P＜0.05). Conclusion LACI could be used to effectively predict LA dysfunction in CKD patients. |
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