三维斑点追踪成像技术评价2型糖尿病患者左心室整体应变

【摘要】目的 运用三维斑点追踪成像技术（3D-STI）测定左心室整体心肌变化，评价2型糖尿病（T2DM）患者的左心室整体心肌的收缩功能。方法 选取2型糖尿病患者81例，依据左心室射血分数（LVEF）分为收缩功能正常组（n=46例）和左心室收缩功能减低组（n=35例），另入选35例健康志愿者作为对照组。使用3D-STI技术测定左心室收缩期短轴整体峰值环向应变（GCS）、径向应变（GRS）、长轴纵向应变（GLS）、面积应变（GAS）及左室扭转（LVTW），并与健康对照组比较。结果 与对照组相比，患者组的GLS、GAS和LVTW均有显著减低(P＜0.05)；左心室LVEF减低组的GAS和LVTW均低于LVEF正常组，差异有统计学意义（P＜0.05）。左心室GAS和GLS同LVEF呈负相关（r分别为﹣0.81和﹣0.62）。 结论3D-STI能准确测定T2DM患者的左心室整体应变，其中GLS、GAS等参数具有一定的临床实用价值。

Three-dimensional speckle tracking imaging in evaluation on global left ventricular strain in patients with type 2 diabetes mellitus

Objective To assess global left ventricular systolic function with three-dimensional speckle tracking imaging (3D-STI) technique in patients with type 2 diabetes mellitus (T2DM). Methods Forty-six T2DM patients with normal left ventricular ejection fraction (LVEF) were randomly enrolled as T2DM group, and 35 healthy volunteers were enrolled as normal controls. Global circumferential strain (GCS), radial strain (GRS), longitudinal strain (GLS), area strain (GAS) and left ventricular twist (LVTW) were measured with 3D-STI. Results GLS, GAS and LVTW were significantly lower in T2DM group than in normal group (all P<0.05). GAS and GLS were negatively correlated with LVEF (r=-0.84, -0.65, all P<0.01), while LVTW was positively correlated with LVEF (r=0.66,P<0.01). Conclusion Global left ventricular strain in T2DM patients could be evaluated with 3D-STI. GAS, GLS and LVTW are clinically valuable in evaluating left ventricular systolic function.