左心房容积追踪技术评价2型糖尿病患者左心房功能  

Assessment of left atrial function in type 2 diabetes mellitus patients with left atrial volume tracking technique

作　　者：王静[1] 黄君红[1] 谢明星[1] 吕清[1] 王新房[1] 丁琳灵[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院超声影像科湖北省分子影像学重点实验室,湖北武汉430022

出　　处：《中国医学影像技术》2010年第6期1065-1068,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨左心房容积追踪(LAVT)技术评价2型糖尿病(T2DM)患者左心房功能变化的临床价值。方法 T2DM患者31例(T2DM组),健康志愿者35名(对照组)。应用HitachiEUB-6500超声诊断仪,获取动态心尖四腔、两腔心的二维灰阶图像储存。启动LAVT模式,分别在上述切面描记左心房内膜。系统自动获取左心房容积及容积-时间变化曲线。记录左心房最大容积(LAVmax)、左心房被动排空容积(LAVp)、左心房最小容积(LAVmin)及收缩期左心房充盈速率峰值(dV/dtS)、舒张早期左心房排出速率峰值(dV/dtE)及舒张晚期左心房排出速率峰值(dV/dtA)。所有容积指标均经体表面积(BSA)标化(LAVImax,LAVIp,LAVImin);计算左心房被动、主动及整体排空容积(LAVIpass、LAVIact、LAVItotal)及左心房被动排出率(%LAVIpass)、主动排出率(%LAVIact)、整体排出率(%LAVItotal)、有效左心房被动、主动排出率(%eLAVIpass、%eLAVIact)及左心房被动与主动排出量比值(LAVpass/act)。结果①与对照组相比,T2DM组LAr、A峰增加,E峰、E/A降低(P<0.05)。②左心房容积曲线图:对应心电图T波末首先出现一个向上的高峰(LAVmax)后,于心电图P波处出现一转折点(LAVp),接着出现向下的小波(LAVmin),左心房容积-时间曲线图则由一个向上的收缩期波(dV/dtS)以及舒张早期、晚期向下的两个波(dV/dtE、dV/dtA)组成。与对照组相比,T2DM组左心房容积曲线的各峰值降低,斜率相对更陡直;二者的容积-时间曲线走行基本一致。③与对照组相比,T2DM组LAVmax、LAVp、LAVmin、dV/dtA、LAVImax、LAVIp、LAVImin、LAVIact、%eLAVIact显著增加;%LAVIpass、%eLAVIpass则显著降低(P<0.05)。结论 T2DM患者早期心脏改变以舒张功能减退为主,左心房助力泵代偿收缩做功增加。LAVT技术能实时追踪T2DM患者的左心房容积变化,较准确评价左心房功能。Objective To explore the clinical value of left atrial volume tracking（LAVT）technique in assessment of the left atrial（LA）function in patients with type 2 diabetes mellitus（T2DM）.Methods Totally 31 T2DM patients and 35 healthy subjects were enrolled in this study.LAVT technique was applied to display the LA volume and volume-time curve images on the apical two-and four-chamber views.The maximal LA volume at end-systole（LAVmax）,LA volume at the onset of ECG-P wave（LAVp）,and the minimal LA volume（LAVmin）from the LA volume curve were recorded.The systolic LA filling rate（dV/dtS）,early and late diastolic LA emptying rates（dV/dtE and dV/dtA）were measured from the volume-time curve.Body surface area was used to revise these volume indexes（LAVImax,LAVIp,LAVImin）.Then LA pass,act and total empting volume（LAVIpass,LAVIact,LAVItotal）and empting rate（%LAVIpass,%LAVIact,%LAVItotal）,effective pass and act empting rate（%eLAVIpass,%eLAVIact）,the proportionality of pass empting volume and act empting volume（LAVpass/act）were caculated.Results ①Compared with the healthy subjects,the value of LAr and Peak A increased,the value of peak E and E/A ratio decreased in T2DM patients（P〈0.05）.②In the left atrial volume curve,there was an upward peak（LAVmax）just at the end of ECG-T wave,and then two little negative waves LAVp and LAVmin occurred after the ECG P-wave.In the left atrial volume-time curve,there was an upward systolic wave（dV/dtS）and two diastolic negative waves（dV/dtE,dV/dtA）.Compared with the healthy subjects,every peak value in left atrial volume curve decreased in T2DM patients,and the slope became steeper;the patterns of left atrial volume-time curve were similar.③LAVmax,LAVp,LAVmin,dV/dtA,LAVImax,LAVIp,LAVImin,LAVIact,%eLAVIact indices in T2DM patients were significantly higher than those of healthy subjects,whereas the %LAVIpass,%eLAVIpass indices were significantly lower than those of healthy subjects（P〈0.05）.Conclusion The major early car

关 键 词：心房功能 左 糖尿病 2型 容积追踪 

分 类 号：R587.1[医药卫生—内分泌] R540.45[医药卫生—内科学]