| Objective: Two-dimensional speckle tracking imaging technology(2D-STI)was used to measure left atrial function and volume-related changes,combined with laboratory indicators(creatinine,uric acid)to assess the progress of patients with chronic kidney disease(CKD).Methods: A total of 84 CKD patients who did not undergo dialysis treatment were enrolled in this study(including 27 in CKD1-2,18 in CKD3,17 in CKD4,and 22 in CKD5)and 19 healthy volunteers(control group).Having collected clinical data and routine ultrasound data,making a off line analysis of two-dimensional spot tracking related data of all subjects in this study.Results:(1)Comparison of clinical related indicators: Compared with the control group,CKD1-2,CKD3,CKD4,and CKD5 groups all had hypertension(P<0.05),and the higher the rate of hypertension as the disease progressed Come higher.(2)Comparison of laboratory indicators: Creatinine and uric acid showed a gradual upward trend with the progress of the disease,and the differences between some groups were statistically significant(P<0.01).(3)Contrast of parameters of conventional echocardiography,PW,TDI:LADd,LVPWd,IVSd,LVDd,LVDs,SV,EF,A,e and other indicators have statistically significant differences between groups(P<0.05).(4)Comparison of left atrial volume related parameters: LAVmax,LAVImax,LASVt,LASVp increased in the control group,CKD1-2 and CKD5 groups,LVApre,LVAIpre,LAVmin,and LAVImin increased in the CKD1-2 and CKD5 groups,the difference between the groups was statistically significant(P<0.05).(5)Comparison of related parameters of left atrial myocardial mechanics:SLAed has an upward trend in the early stage of the disease,and gradually decreases with the progress of the disease;SLAac increases first and then gradually decreases with the progress of the disease;SLAsp has an upward trend in the early stage of the disease,and as the disease continues to CKD3,CKD4,CKD gradually decreases at stage 5;SLAcp gradually decreases during the development of the disease;SLAas first increases and then gradually decreases as the disease progresses.(6)Comparison of ROC curve: The combined application of left atrial strain index and laboratory index can partially improve the diagnostic efficiency of patients with CKD3 and CKD5.Conclusion: 1.Early heart injury in CKD patients has already occurred.2D-STI can detect left atrial dysfunction in CKD3 and CKD4,and can remind heart damage in CKD patients early.2.Laboratory indicators such as uric acid and creatinine can indicate early renal decompensation.3.2D-STI measurement of left atrial strain combined with serological indicators can partially improve the diagnostic efficiency of patients with CKD3 and CKD5. |
