超声二维斑点追踪显像技术评价2型糖尿病患者左心室心肌扭转运动及其与C肽水平的关系  

Assessment of Left Ventricular Twist in Type 2 Diabetes Mellitus by Two- dimensional Ultrasound Speckle Tracking Imaging and Its Relationship with the Level of Serum C Peptide

作　　者：朱培华[1] 黄敬垣[1] 叶萌[1] 

机构地区：[1]浙江医院超声科,浙江省杭州市310013

出　　处：《中国全科医学》2014年第18期2156-2159,共4页Chinese General Practice

摘　　要：目的探讨超声二维斑点追踪显像技术(STI)评价2型糖尿病患者左心室心肌扭转运动的特点及其与空腹血清C肽水平的关系。方法选取2012年5月—2013年9月浙江医院门诊或住院确诊为2型糖尿病的患者93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组(A组,LVEF≥0.50)46例、糖尿病左心室收缩功能衰竭组(B组,LVEF<0.50)47例,另选择同时期我院体检中心体检健康者46例为对照组。采集空腹血清检测C肽水平;采用常规超声心动图检测左心室舒张末期内径(LVEDD)、左心房前后径(LAD)、室间隔舒张末期厚度(IVS)、左心室后壁舒张末期厚度(LVPW)、左心室短轴缩短率(LVFS)、LVEF、左房室瓣口E峰值/左房室瓣口A峰值(E/A)、左房室瓣口血流频谱E峰/组织多普勒左房室瓣环运动e峰(E/e);采用STI计算出左心室扭转角度峰值(Peaktw)、主动脉瓣关闭时间点扭转角度(AVCtw)、左房室瓣开放时间点扭转角度(MVOtw)。结果与对照组比较,A组和B组血糖、糖化血红蛋白(HbA1c)水平升高,C肽水平降低,A组IVS、LVPW、E/e、Peaktw、AVCtw、MVOtw升高,B组LVEDD、LAD、E/e升高,B组LVFS、LVEF、E/A、Peaktw、AVCtw、MVOtw降低(P<0.05);与A组比较,B组血糖、HbA1c、LVEDD、LAD、E/e升高,C肽水平、LVFS、LVEF、E/A、Peaktw、AVCtw、MVOtw降低(P<0.05)。2型糖尿病患者Peaktw、AVCtw、MVOtw与空腹血清C肽水平均呈正相关(r值分别为0.763、0.756和0.738,P<0.05)。结论 STI能够早期识别2型糖尿病患者左心室收缩功能的异常变化,参考空腹血清C肽水平,可了解2型糖尿病患者左心室收缩功能的状态。Objective To evaluate the left ventricular twist in patients with type 2 diabetes mellitus（T2DM）by two-dimensional speckle tracking imaging（ STI ）and its relationship with the level of fasting serum C peptide. Methods 93 out-patients and inpatients diagnosed as T2DM in Zhejiang Hospital from May 2012 to September 2013 were selected and divided into group A（normal left ventricular systolic function group,LVEF≥0. 50,46 cases）and group B（abnormal left ventricular systolic function group,LVEF〈0. 50,47 cases）. Another 46 healthy people having physical examination over the same period were selected as the control group. The levels of fasting serum C peptide were obtained,and the left ventricular end-diastolic diameter（ LVEDD）,left atrial diameter（ LAD）,interventricular septum end-diastolic thickness（ IVS）,left ventricular back wall end-diastolic thickness（ LVPW）,left ventricular shortaxis shortening rate（ LVFS）,LVEF,mitral valve E peak/mitral valve A peak（ E/A）,mitral valve flow spectrum E peak/tissue Doppler mitral valve ring motion e peak（ E/e）were detected by conventional echocardiography. The peak of left ventricular twist angle （ Peaktw ）, aortic valve closure time twist angle （AVCtw）and mitral valve opening time twist angle（MVOtw）were calculated by STI. Results Compared with the control group,the blood glucose,HbA1c increased,but the C peptide levels were lower in group A and group B. The IVS,LVPW,E/e,Peaktw,AVCtw and MVOtw were increased in group A,while the LVEDD,LAD and E/e were increased and the LVFS, LVEF,E/A,Peaktw,AVCtw and MVOtw were decreased in group B（P〈0. 05）. Compared with group A,the blood glucose,HbA1c,LVEDD,LAD and E/e in group B were higher,while the C peptide,LVFS,LVEF,E/A,Peaktw,AVCtw and MVOtw were lower（P〈0. 05）. The Peaktw,AVCtw and MVOtw were positively correlated with fasting C peptide in T2DM patients（r=0. 763,0. 756 and 0. 738,P〈0. 05）. Conclusion STI can be used for early detection of T2DM with abnormal change

关 键 词：糖尿病 2型 超声心动描记术 心室功能 左 C肽 

分 类 号：R587.1[医药卫生—内分泌]