三维斑点追踪成像定量评价2型糖尿病患者左室收缩功能

目的探讨三维斑点追踪成像(3D-STI)技术在定量评价2型糖尿病(T2DM)患者左室整体收缩功能早期改变中的作用。方法选取80例T2DM患者,根据左室射血分数(LVEF)水平分为DM1组50例(LVEF≥50%)和DM2组30例(LVEF<50%),另选42例健康志愿者为对照组。常规超声检测各组左房内径、左室内径、室间隔厚度、左室后壁厚度、LVEF、二尖瓣口舒张早晚期峰值血流速度(E、A)及E/A;3D-STI技术测量左室收缩期峰值整体纵向应变(GLS)、整体径向应变(GRS)、整体圆周应变(GCS)及整体面积应变(GAS)。比较各组上述参数。结果各组间左房内径、室间隔厚度、左室后壁厚度、E/A比较差异均有统计学意义(均P<0.05)。与对照组比较,DM1组GLS、GCS、GAS均减低(-14.254±3.005)%vs.(-17.530±3.358)%,(-23.117±4.441)%vs.(-28.982±6.029)%,(-37.064±5.231)%vs.(-41.594±7.569)%,GRS增高(-28.151±11.190)%vs.(21.629±12.972)%,差异均有统计学意义(均P<0.05);DM2组GLS、GCS、GAS均减低(均P<0.05),而GRS比较差异无统计学意义。DM2组GLS、GCS、GRS、GAS均较DM1组减低,差异均有统计学意义(均P<0.05)。结论3D-STI可早期检测T2DM患者左室收缩功能的异常,是评估糖尿病患者心功能的可靠方法。

Quantitative evaluation of left ventricular systolic function in patients with type-2 diabetes mellitus by three-dimensional speckle tracking imaging

Objective To quantitatively evaluate the early changes of left ventricular(LV)global systolic function in patients with type-2 diabetes mellitus(T2DM)by three-dimensional speckle tracking imaging(3D-STI).Methods Eighty T2DM patients(case group)were selected and divided into two groups according to the left ventricular ejection fraction(LVEF):50 patients in DM1 group(LVEF≥50%)and 30 patients in DM2 group(LVEF<50%).And 42 healthy volunteers(control group)were selected in the control group.The general clinical date,conventional ultrasonic parameters(LA,LVIDd,IVSd,LVPWd,LVEF,E/A)and 3D-STI parameters,including global systolic peak longitudinal strain(GLS),global radial strain(GRS),global circumferential strain(GCS)and global area strain(GAS)of left ventricle in the three groups were measured and compared.Results There were significant differences in LA,IVSd,LVPWd,E/A among the groups(all P<0.05).Compared with control group,GLS,GCS and GAS in DM1 group were decreased significantly(-14.254±3.005)%vs.(-17.530±3.358)%,(-23.117±4.441)%vs.(-28.982±6.029)%,(-37.064±5.231)%vs.(-41.594±7.569)%,while GRS was increased significantly(-28.151±11.190)%vs.(21.629±12.972)%,there were significantly differences(all P<0.05).GLS,GCS and GAS in DM2 group were significantly decreased(all P<0.05),while GRS had no difference.In addition,GLS,GCS,GRS and GAS in DM2 group were significantly lower than those in DM1 group(all P<0.05).Conclusion 3D-STI can be used to detect early left ventricular systolic dysfunction in T2DM patients,and is a reliable method to evaluate early abnormal heart function in diabetic patients.