三维斑点追踪技术对2型糖尿病患者左心室心肌应变的分析  

作　　者：马晓棠[1] 李敏[1] 黄敬垣[1] 江雪燕[1] 何娴[1] 汪文杰[1] 

机构地区：[1]浙江医院B超室,310013

出　　处：《浙江临床医学》2015年第4期513-515,共3页Zhejiang Clinical Medical Journal

摘　　要：目的：采用三维斑点追踪技术（3DT）探讨2型糖尿病（T2DM）患者左心室心肌三维整体应变参数的变化特点及其评估左心功能的临床价值。方法选取T2DM患者93例，并根据心尖双平面Simpson法所获取的左心室射血分数（LVEF）分为A组（LVEF≥0.50，46例）和B组（LVEF〈0.50，47例），另选取健康体检者46例作为对照组，采用3DT获得左心室心肌三维整体应变参数，包括GLS、GCS，GRS和GAS。结果与对照组比较，A组的GAS、GLS均下降（P均〈0.05）；与对照组、A组比较，B组的GAS、GLS、GCS、GRS均下降（P均〈0.05）。T2DM患者的GAS（r=0.88）、GLS（r=0.82）、GCS（r=0.78）、GRS（r=0.76）与LVEF均呈正相关（P均〈0.05）；ROC曲线分析显示GAS、GLS、GCS、GRS判断T2DM患者左心功能异常时均有中等诊断价值，其中GAS的诊断效能最高；一致性检验显示，三维整体应变参数具有较好的一致性。结论3DT能无创性早期客观地评价T2DM患者的左心功能，并具有较好的稳定性和重复性。Objective To evaluate left ventricular myocardial three-dimensional overall strain parameters change characteristics in patients with type 2 diabetes mellitus（T2DM）using three-dimensional speckle tracking（3DT）,and its clinical value . Methods This study included 93 cases with T2DM,who were divided into two groups according to LVEF：group A,LVEF≥0.50,included 46 cases and group B,LVEF〈0.50,included 47cases;and control group included 46 cases. 3DT was applied for left ventricular myocardial three-dimensional overall strain parameters：global longitudinal strain（GLS）,global circumferential strain（GCS）,global radial strain（GRS）,global area strain（GAS）. Result Compared with control group,group A GAS,GLS decreased,P〈 0.05;Compared with control group,group A,group B GAS,GLS,GCS,GRS decreased,P〈0.05. Correlation analysis showed that GAS（r=0.88）,GLS（r=0.82）,GCS（r=0.78）,GRS（r=0.76）and LVEF were positively correlated（P〈0.05）in patients with T2DM;ROC curve analysis showed that： GAS,GLS,GCS,GRS judgment in abnormal left ventricular function in patients with T2DM were medium diagnostic value. GAS had the highest efficiency of diagnosis;Consistency check showed that：the left ventricular myocardial three-dimensional overall strain parameters had good consistency. Conclusions 3DT can early non-invasive objectively evaluate left ventricular function in patients with T2DM early and non-invasively,and has good stability and repeatability.

关 键 词：三维斑点追踪技术 糖尿病 左心室功能 

分 类 号：R542.22[医药卫生—心血管疾病]