二维斑点追踪分层应变技术评价单纯2型糖尿病患者左室收缩功能的研究  

Evaluation on the left ventricular systolic function in patients with simple type 2 diabetes mellitus by two-dimensional layer-specific speckle-tracking

作　　者：高赟[1] 延东娥[2] 冯晓冰 

机构地区：[1]四川大学华西医院内分泌代谢科,成都市610041 [2]成都市第一人民医院心功能科 [3]四川大学华西临床医学院

出　　处：《临床超声医学杂志》2017年第10期674-678,共5页Journal of Clinical Ultrasound in Medicine

基　　金：成都市卫生局青年基金课题(2013079)

摘　　要：目的探讨单纯2型糖尿病患者左室各层及各节段心肌收缩功能的早期变化情况。方法选取60例血压和冠状动脉正常的单纯2型糖尿病患者(病例组)和60例健康志愿者(对照组),应用二维斑点追踪分层应变技术测量两组左室心肌内层、中层、外层及基底段、中间段、心尖段心肌的纵向应变峰值(GLS)、圆周应变峰值(GCS)及径向应变峰值(GRS),结果进行比较分析。结果两组左室心肌GLS和GCS均由内至外逐层递减,从基底段至心尖段逐段增加(P<0.01),对照组心尖段GRS较中间段和基底段明显减低(P<0.05),病例组心尖段GRS较基底段明显减低(P<0.05);病例组各层及各节段GLS均较对照组对应层次和对应节段明显减低(均P<0.05),中间段GCS较对照组明显减低(P<0.05),心尖段GRS较对照组明显减低(P<0.05)。结论 2型糖尿病患者在射血分数降低前已存在左室心肌和收缩功能损伤,心脏长轴方向的收缩功能和中下份心肌受损更明显。Objective To evaluate the early change of left ventricular systolic function in patients with type 2 diabetes mellitus(T2DM) by two-dimensional layer-specific speckle-tracking technique.Methods Sixty T2DM patients without hypertension and coronary artery disease,and 60 normal controls were enrolled in this study.Global longitudinal strains(GLS),global circumferential strains(GCS)and globalradial strains(GRS)of three myocardial layers(endocardial,mid-myocardial and epicardial) and three segments(basal,middle and apex) were measured by two-dimensional layer-specific speckle-tracking technique.Data of GLS,GCS and GRS were compared between T2DM group and the control group.Results Among all subjects,GLS and GCS decreased gradually from the endocardial layer to the epicardial layer but increased gradually from the basal segment to the apex segment(P<0.01).Moreover,in both groups,GRS in the apex segment was lower than that in the basal segment(P<0.05).GLS of the three myocardial layers,the basal segment and the middle segment in T2DM group were lower than those in control group(all P<0.05).Compared to the control group,the GCS of the middle segment and the GRS of the apex segment of patients with T2DM were lower(all P <0.05).Conclusion The left ventricular systolic dysfunction decreased prior to the ejection fraction decreasing in patients with T2DM,especially the long-axis global systolic function and the middle-apex segments of the left ventricle maybe easily damaged.

关 键 词：斑点追踪成像 分层应变 二维 收缩功能 心室 左 糖尿病 2型 

分 类 号：R331.31[医药卫生—人体生理学] R540.45[医药卫生—基础医学]