组织同步成像技术评价2型糖尿病患者左心室运动同步性的研究  

The tissue synchronization imaging in assessing movement synchrony of the left ventricle in patients with type 2 diabetes mellitus

作　　者：张亚菲[1] 孙丽[1] 叶玉泉[1] 薛红元[1] 王小平[1] 焦荣红[1] 牛慧敏[1] 

机构地区：[1]河北省人民医院超声科,石家庄050051

出　　处：《疑难病杂志》2016年第6期567-570,574,F0003,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省医学科学研究重点课题计划(ZL20140253)

摘　　要：目的应用组织同步成像技术(TSI)研究2型糖尿病患者左心室是否存在不同步运动以及糖尿病微血管并发症对心脏运动同步性的影响。方法 2014年11月—2015年4月收集河北省人民医院超声科行心功能检查的2型糖尿病患者60例,然后将病例按照是否伴有糖尿病视网膜病变、糖尿病肾病等微血管并发症分为2组:糖尿病无微血管并发症组(TDM1)30例和糖尿病微血管并发症组(TDM2)30例;同时选择查体无明显异常的健康志愿者30例作为健康对照组(NC)。均经常规超声心动网及TSI技术检查,记录常规超声心动图左室相关参数及左室壁基底段和中间段各节段心肌收缩的峰值时间(Ts),系统会自动显示部分心肌节段收缩的峰值时间差,即延迟时间(TSI指数),包括基底段侧壁与基底段后间隔收缩的峰值时间差(SLD)、基底段后壁与基底段前间隔收编的峰值时间差(SPD)、所有基底段中最大收缩峰值时间差(BMD)、所有基底段收缩峰值时间的标准偏差(BS)、所有节段中最大收缩峰值时间差(aSMD)和所有节段收缩峰值时间的标准偏差(aSS)等6个与左心室运动同步性相关的参数,各组之间进行比较。结果 NC组、TDM1组、TDM2组之间的性别、年龄及常规超声心动图左室相关参数比较差异均无统计学意义(P>0.05)。与NC组比较,TDMI组、TDM2组左室运动同步性相关参数均明显延迟,差异均有统计学意义(P<0.01),TDM2组左室运动同步性相关参数与TDM1组比较,差异有统计学意义(P<0.01)。TDM1组、TDM2组患者左室非同步运动发生率均高于NC组,其差异有统计学意义(X^2=45.882、60.000,P<0.05),但是TDM2组与TDM1组左室非同步发生率比较,差异没有统计学意义(X^2=4.286,P>0.05)。结论 TSI可以对2型糖尿患者左室运动同步性进行方便、快捷的评估;2型糖尿病患者存在左室的非同步运动,同时在伴有糖尿病微血管并发症的糖尿病患者中,左室的非同步�Objective To evaluate the left ventricular synchronized motion in the patients with type 2 diabetes mellitus and the effect of diabetic microangiopathy on the cardiac synchronicity by using tissue synchronization imaging（TSI）.Methods From November 2014 to April 2015,sixty patients with type 2 diabetes mellitus were selected.According to whether it is associated with microvascular complications such as diabetic microangiopathy and diabetes nephropathy,these patients were divided into two groups;diabetes with non microvascular complications group（TDM1）and diabetic microvascular complications group（TDM2）,each group having 30 individuals.At the same time,30 healthy volunteers,who were confirmed normal in the physical examination,were selected as the normal control（NC）group.All of the people underwent conventional echocardiography and TSI.Recording the left ventricular parameters of Conventional Echocardiography and the myocardial contractile peak value time（Ts） of each segments in the the basal segment and the middle segment of left ventricular wall.System will automatically display part of myocardial segments＇ s contractile peak delay,which is the delay time index（TSI）.The index of TSI includes six parameters which related to the left ventricular synchrony：septal Lat delay（SLD）,septal Post delay（SPD）,basal max delay（BMD）,basal stdev（BS）,all seg max delay（aSMD）and all segments stdev（aSS）,and compared between groups.Results The gender,age and the left ventricular parameters of conventional echocardiography in TDMl,TDM2 and NC group had no statistical difference（P〈0.05）.Compared with the NC group,the left ventricular movement synchronized releated parameters of TDMl and TDM2 group both distingctly delayed,the differences were statistically significant（P〈0.01）,and significant differences were also found between the TDMl group and the TDM2 group（P〈0.01）.The incidences of the left ventricular asynchrony in TDMl and TDM2 group were higher than that in NC

关 键 词：组织同步成像技术 左心室运动同步性 超声心动图 糖尿病 糖尿病微血管并发症 

分 类 号：R587.2[医药卫生—内分泌] R445.1[医药卫生—内科学]