超声斑点追踪成像技术对2型糖尿病患者左心室扭转运动早期变化的初步研究

目的 探讨超声斑点追踪成像技术评价2型糖尿病患者左心室扭转运动早期变化的临床应用价值.方法 2型糖尿病患者66例,且左心室射血分数≥50%,其中单纯糖尿病41例,糖尿病并左心室肥厚25例,正常对照者37例.采集受检者胸骨旁短轴二尖瓣水平、心尖水平二维图像,测量各水平收缩期平均旋转角度峰值、各室壁节段旋转角度峰值,计算左心室整体扭转角度峰值.结果 与对照组比较,单纯糖尿病组各水平平均旋转角度峰值、心尖水平各室壁节段旋转角度峰值及左心室整体扭转角度峰值均较对照组增大（P＜0.05或P＜0.01）.糖尿病并左心室肥厚组二尖瓣水平部分室壁节段、心尖水平各室壁节段旋转角度峰值及各水平平均旋转角度峰值较对照组增大（P＜0.05或P＜0.01）,心尖水平部分室壁节段旋转角度峰值及平均旋转角度峰值较单纯糖尿病组增大（P＜0.05或P＜0.01）,左心室整体扭转角度峰值较正常对照组和单纯糖尿病组大（P＜0.01）.结论 在左心室收缩功能正常时,单纯糖尿病患者左心室扭转角度增大,合并左心室肥厚者更加明显,超声斑点追踪成像能够较早识别糖尿病患者左心室扭转角度改变.

Early change of left ventricular torsion evaluated by ultrasound speckle tracking imaging in patients with type 2 diabetes mellitus

Objective To assess left ventricular （LV） torsion in patients with type 2 diabetes mellitus （DM） by ultrasound speckle tracking imaging （STI）. Methods The STI was performed in 103 subjects with normal ejection fraction including 41 subjects with diabetes mellitus only （ DM group）, 25 subjects with both diabetes and left ventricular hypertrophy （DH group）, and 37 healthy subjects as control group. Two-dimensional strain images were collected from LV short-axis views at the levels of mitral annulus and apex. The LV peak systolic global and the segmental rotation at above levels, and the peak systolic global torsion were calculated. Results The LV peak systolic rotation of all apical segments, systolic global rotation of each plane, and peak systolic global torsion in DM group and DH group, and peak rotation of part segments at mitral annulus level in DH group were significantly increased than those in control group （P 〈0.05 or P 〈0.01 ）. The peak systolic rotation of part segments and systolic global rotation at apex level , and peak systolic global torsion in DH group were higher than those in DM group （ P 〈 0.05 or P 〈 0.01 ）. Conclusions The LV systolic torsion was increased in patients with DM, especially in patient with DH. The uhrasound specking tracking im- aging could accurately and reliably measure deformation of LV torsion in subjects with type 2 diabetes mellitus.