超声二维斑点追踪显像技术对2型糖尿病患者左心室扭转运动的分析  

Assessment of left ventricular twist in type 2 diabetes mellitus by two-dimensional speckle tracking imaging echocardiography

作　　者：何娴[1,2] 郑哲岚[1] 黄敬垣[1] 杨性安[1] 叶萌[1] 杨继东[1] 

机构地区：[1]浙江大学医学院附属第一医院超声科,浙江杭州310003 [2]中国人寿保险股份有限公司浙江省分公司

出　　处：《上海医学》2013年第9期792-795,733,共4页Shanghai Medical Journal

摘　　要：目的应用超声二维斑点追踪显像技术(STI)探讨2型糖尿病患者左心室心肌扭转运动的特点。方法 2型糖尿病患者67例,根据左心室射血分数(LVEF)分为糖尿病左心室收缩功能正常(LVEF≥0.50)组(左心正常组,33例)和糖尿病左心室收缩功能衰竭(LVEF<0.50)组(左心衰竭组,34例)。另33名体格检查示健康者入选正常对照组。定量分析3组受检者的左心室扭转情况。结果左心正常组的左心室扭转角度峰值(Peaktw)、主动脉瓣关闭时间点扭转角度(AVCtw)、二尖瓣开放时间点扭转角度(MVOtw)均显著高于正常对照组(P值均<0.01),左心衰竭组均显著低于左心正常组和正常对照组(P值均<0.01)。左心正常组和左心衰竭组的等容解旋比例(IUR)、解旋率(UntwR)均显著低于正常对照组(P值均<0.05),解旋减半时间(UHT)均显著长于正常对照组(P值均<0.05),前两组间的差异也有统计学意义(P值分别<0.05、0.01)。糖尿病患者的Peaktw(r=0.774)、AVCtw(r=0.756)、MVOtw(r=0.728)与LVEF呈正相关(P值分别<0.01、0.05),而二尖瓣口血流频谱E峰值与组织多普勒二尖瓣环运动e峰值比值与LVEF不相关(P>0.05)。结论 STI能早期识别2型糖尿病患者的心功能异常变化。Objective To evaluate the left ventricular twist by two-dimensional speckle tracking imaging （STI） in patients with type 2 diabetes. Methods According to the results of left ventricular ejection fraction （LVEF）, 67 patients with type 2 diabetes were divided into group A （LVEF≥0.50, n = 33） and group B （LVEF〈 0.50, n = 34）. Moreover, 33 healthy volunteers were taken as normal controls. STI echocardiography was used for quantitative analysis of left ventricular twist in all subjects. Results The peak of left ventricular twist angle （Peaktw）, aortic valve closure time twist angle （AVCtw） , mitral valve opening time twist angle （MVOtw） in group A were significantly higher than those in normal control group （all P〈0. 01 ）. However, the above- mentioned parameters in group B were all significantly lower than those in the normal control group and group A Call P〈0.01）. Compared with healthy volunteers, both isopyknic unwinding ratio （IUR） and unwinding rate （UntwR） were significantly decreased, but time unwinding in half （UHT） was significantly delayed in the patients with type 2 diabetes mellitus （all P〈0.05）. There were also significant differences in IUR, UntwR and UHT between group A and B （P〈0.05 or P〈0.01）. Peaktw, AVCtw and MVOtw were positively correlated to LVEF in the patients with diabetes （r=0.774, 0.756, 0.728, P〈0.05 or P〈0.01）. But the value of E/e was not related to LVEF （P〉0.05）. Conclusion Early cardiac disfunction can be detected by two-dimensional speckle tracking imaging in.patients with type 2 diabetes mellitus.

关 键 词：超声心动描记术 超声二维斑点追踪显像技术 扭转 糖尿病 左心室功能 

分 类 号：R587.2[医药卫生—内分泌]