三维斑点追踪成像评价短期胰岛素泵治疗对2型糖尿病患者左心室收缩功能的改善作用  

Effect of short-term patients evaluated by insulin pump therapy on left ventricular systolic function in type 2 diabetes mellitus speckle tracking imaging

作　　者：周小玲[1] 田新桥[3] 胡路路 李秀云[1] 蒋盼盼[1] 吴朝明[2] 潘优津[2] 

机构地区：[1]温州医科大学附属第二医院超声科,325027 [2]温州医科大学附属第二医院内分泌科,325027 [3]河南省人民医院(郑州大学人民医院)超声科

出　　处：《中华超声影像学杂志》2016年第2期116-121,共6页Chinese Journal of Ultrasonography

摘　　要：目的应用三维斑点追踪成像（3D-STI）技术评价2型糖尿病（T2DM）患者经胰岛素泵短期强化治疗后左心室收缩功能的改善情况。方法选择合并微血管病变的T2DM患者35例（糖尿病组），健康志愿者32例（对照组）。采集左室全容积图像，将全容积图像输入TomTee工作站，计算左室整体纵向应变（LVGLS）、左室整体圆周应变（LVGCS）、左室基底段与心尖段旋转角度峰值（Lv-ProtB、LV-ProtA）、左室扭转角度峰值（LV-tw）、左室扭力（LV-tor）、左室射血分数（LVEF）等参数。糖尿病患者在应用胰岛素泵强化治疗2周后重复检测。结果与对照组比较，糖尿病组治疗前、后的LVGLS、LVGCS、LV-tw、LV-ProtA均减低，差异有统计学意义（P〈0．01或P〈0．05）；与糖尿病组治疗前比较，糖尿病组治疗后的LVGLS、LVGCS均增高。差异有统计学意义（P〈0．05）；糖尿病组治疗前、后及对照组的LVGLS、LVGCS、LV-tw、LV-protA与LVEF均存在良好的相关性。结论合并微血管病变的T2DM患者应用胰岛素泵短期强化治疗后左室收缩功能有所改善，3D-STI可敏感、准确地评估治疗效果，具有重要临床应用价值。Objective To assess the improvements of left ventricular systolic function by three- dimensional speckle tracking imaging （3D-STI） in type 2 diabetes mellitus （T2DM） patients after short- term insulin pump intensive therapy. Methods Thirty-five T2DM patients complicated with microangiopathy and thirty-two healthy volunteers were studied, underwent the dynamic image of the four- chamber view, three-dimensional images of left ventricle were obtained for all the individuals. The left ventricular global longitudinal strain （LVGLS）, left ventricular global circumferential strain （LVGCS）, left ventricular ejection fraction （LVEF）, peak basal and apical rotation （LV-ProtB, LV-ProtA）, peak LV twist （LV-tw） were calculated using TomTec software. After insulin pump intensive therapy for two weeks, all the indexes were reexamined in T2DM patients. Results Compared with control group, the LVGLS, LVGCS, LV-tw and LV-ProtA were significantly decreased in diabetes mellitus group before and after treatment （P 〈0.01 or P 〈0.05）. Compared with diabetes mellitus patients before treatment, the LVGLS, LVGCS had significant higher level after treatment（ P 〈0.05）. The LVGLS, LVGCS, LV-tw and LV-ProtA were significantly correlated with LVEF in type 2 diabetes mellitus patients and normal controls. Conclusions Insulin pump intensive treatment could improve left ventricular systolic function in type 2 diabetes patients complicated with microangiopathy. 3D-STI can be sensitive to accurately assess the therapeutic effect and has the important clinical value.

关 键 词：超声心动描记术 糖尿病  2型 胰岛素泵强化治疗 三维斑点追踪成像 

分 类 号：R540.45[医药卫生—心血管疾病] R587.1[医药卫生—内科学]