应变率成像技术评价GHb异常糖尿病患者左室舒张功能的临床研究

目的利用超声应变率显像(SRI)技术评价糖化血红蛋白(GHb)异常的2型糖尿病(DM2)患者左室舒张功能。方法应用SRI技术分别观测GHb异常(>6.07%)DM2患者(DM2组,n=40)及GHb正常(4.17%~6.07%)健康成年人(NOR组,n=37)心尖四腔切面、心尖二腔切面及心尖左室长轴切面左室6个室壁(后间隔、侧壁、前壁、下壁、前间隔、后壁)中间段的舒张早期峰值SR(SRe)、舒张晚期峰值SR(SRa),并计算SRe/SRa。结果(1)与NOR组相比,DM2组的SRe,SRe/SRa显著减低,有统计学意义;而SRa稍高,但无统计学意义。(2)DM2患者GHb与SRe呈显著负相关,而与SRa呈正相关;以SRe/SRa<1,E/A<1等提示舒张功能减退,与NOR组相比,DM2组有统计学意义。(3)DM2组心尖四腔、心尖二腔及心尖左室长轴切面观上左室6个壁中间段的SRe和SRa,各室壁间无显著性差异。结论超声SRI技术能较好地评价GHb异常DM2的心脏舒张功能。

Clinical Study on Strain Rate Imaging Evaluating Left Ventricular Diastolic Function in Diabetic Patients with Abnormal Glycosylated Hemoglobin

Objective To evaluate left ventricular diastolic function of patients with abnormal glycosylated hemoglobin(GHb) type 2 diabetes mellitus(DM2) by using ultrasounic strain rate imaging(SRI).Method The early diastolic peak SR(SRe) and the advanced diastolic peak SR(SRa) at middle of six walls of left ventricular(posterior septal,sidewall,anterior,inferior,anterior septum,posterior wall) were performed by SRI in DM2 patients with abnormal GHb(>6.07%)(DM2 group,n=40) and normal GHb(4.17%～6.07%) healthy adults(NOR group,n=37) at four-chamber view,two-chamber view and apical long axis view.SRe/SRa was calculated.Results(1)Compared with NOR group,Sre,SRe/Sra and E/A in DM2 group reduced significantly.There was a significant difference.SRa was slightly higher,but there was no statistical difference.(2)GHb was negatively correlated with SRe in DM2 group,and was positively correlated with SRa.If SRe/SRa<1 and E/A<1 were considered as diastolic dysfunction parameters,DM2 group was statistically different from NOR group.(3)SRe and SRa of each chamber central part were not statistically different.Conclusions SRI could evaluate left ventricular diastolic function of patients with abnormal GHb DM2.