应变率成像技术评价2型糖尿病患者左室舒张功能的临床研究

目的应用应变率成像(SRI)技术定量评价2型糖尿病(T2DM)患者左室舒张功能,探讨其在早期诊断T2DM患者左室舒张功能异常中的应用价值。方法应用SRI技术获取30例T2DM患者(T2DM组)和30例健康体检者(对照组)左室各室壁三节段心肌应变率曲线,测量并比较左室各节段舒张早期应变率(SRe)和舒张晚期应变率(SRa),计算SRe/SRa。结果与对照组比较,T2DM组常规测量指标(LAD、IVS、LVEDD、E/A、LVEF和DT)差异无统计学意义;与对照组比较,T2DM组SRe和SRe/SRa均减低,各室壁相同节段差异均有统计学意义(P0.05),而SRa在两组间相同节段差异均无统计学意义(P0.05);两组内自身三节段间的比较,对照组三节段间各应变率指标(SRe、SRa和SRe/SRa)比较差异均无统计学意义(P0.05);T2DM组三节段间比较从基底段到心尖段SRe/SRa依次递减,差异有统计学意义(P0.05),SRe和SRa差异无统计学意义。结论 SRI技术能评价糖尿病患者左室舒张功能异常,SRe和SRe/SRa是评价T2DM患者舒张功能异常的敏感指标。

Clinical study on strain rate imaging in evaluation of left ventricular diastolic function in patients with type 2 diabetes mellitus

Objective To evaluate quantitatively left ventricular diastolic function in patients with type 2 diabetes mellitus（T2DM）using strain rate imaging（SRI）,and explore its application value in early diagnosis of left ventricular diastolic dysfunction in patients with T2 DM. Methods Thirty patients with T2 DM and 30 healthy subjects were enrolled. The strain rate of early and late diastole（SRe and SRa）were acquired in all left ventricular wall（anterior wall,inferior wall,posterior wall,lateral wall,anterior septum and posterior septum）at three levels（basal,middle and apical level）by SRI. The ratio of SRe/SRa was calculated. Results There were no significant differences in the general indicators（LAD,IVS,LVEDD,E/A,LVEF and DT）between the two groups.Compared with control group,SRe and SRe/SRa decreased in T2 DM group（P0.05）. But there were no significant differences in SRa of same segments between the two groups（P 0.05）. The compare was performed in the three segments of the two groups themselves. The indicator of strain rate（SRe,SRa and SRe/SRa）were no significant differences in the three segments of control group（P0.05）. In T2 DM group,the SRe/SRa decreased progressively from basal to apical segment,and there were significant differences（P0.05）,but the SRe and SRa showed no significant differences（P0.05）. Conclusion SRI can evaluate left ventricular diastolic dysfunction in patients with T2 DM,the SRe and SRe/SRa are sensitive indicators of diastolic dysfunction.