斑点追踪成像技术评价糖尿病肾功能不全患者左室收缩功能的研究  

Evaluation of left ventricular systolic function in diabetic renal insufficiency by speckle tracking imaging

作　　者：刘滨月[1] 王俊芳[1] 贾保霞[1] 罗婷婷[2] LIU Binyue;WANG Junfang;JIA Baoxia;LUO Tingting(Department of Ultrasound,Longgang Central Hospital of Shenzhen,Shenzhen 518116,China)

机构地区：[1]深圳市龙岗中心医院超声科,518116 [2]深圳市第三人民医院超声科

出　　处：《临床超声医学杂志》2018年第11期759-762,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨斑点追踪成像技术评价糖尿病肾功能不全患者左室收缩功能的价值。方法选取我院内分泌科因糖尿病导致肾功能不全的患者50例为观察组,同期健康体检的志愿者50例为对照组,均行肾功能生化指标、常规超声及斑点追踪成像检查,分析并比较两组实验室指标和超声参数。超声检查心功能参数主要有室间隔舒张末期厚度(IVSTd)、左室后壁舒张末期厚度(LVPWd)、左室舒张末期内径(LVDd)、左室收缩末期内径(LVDs)、左室射血分数(LVEF)、二尖瓣口舒张期血流速度E峰和A峰比值(E/A)、二尖瓣环处舒张早期与舒张晚期心肌运动峰值速度比值(Em/Am),以及左室长轴、短轴的心内、外膜层心肌收缩期纵向峰值应变值(LPSS)、径向峰值应变值(GSR)。结果与对照组比较,观察组内生肌酐清除率显著降低,血尿素氮、血浆非蛋白氮和血肌酐水平均显著升高(均P<0.05)。两组IVSTd、LVPWd、LVDd、LVDs和LVEF比较差异均无统计学意义;观察组E/A和Em/Am均较对照组显著减小(均P<0.05)。对照组左室基底段、中间段、心尖段及整体的心内膜层LPSS均较其心外膜层显著升高(均P<0.05);观察组左室各节段及整体的心内膜层与心外膜层LPSS比较差异均无统计学意义;观察组左室各节段及整体的心内膜层、心外膜层LPSS均较对照组显著降低(均P<0.05)。对照组二尖瓣、乳头肌、心尖水平及整体的心内膜层GSR均较心外膜层显著升高(均P<0.05);观察组各水平及整体的心内膜层、心外膜层GSR均较对照组显著升高(均P<0.05)。结论斑点追踪成像技术能有效评估糖尿病肾功能不全患者左室收缩功能变化,可作为其早期诊断的重要手段。Objective To explore the value of speckle tracking imaging in the evaluation of left ventricular systolicfunction in patients with diabetic renal insufficiency.Methods Fifty patients with diabetic renal insufficiency from the departmentof endocrinology （observation group）and 50 healthy volunteers （control group）were enrolled in this study.Renal function tests,conventional ultrasound and speckle tracking imaging were performed in all cases.The conventional ultrasound parametersincluded： interventricular septum end-diastolic thickness （IVSTd）, left ventricular posterior wall end-diastolic thickness （LVPWd）,left ventricular end-diastolic diameter （LVDd）, left ventricular end systolic diameter（LVDs）, left ventricular ejection fraction（LVEF）, mitral diastolic blood flow velocity E peak and A peak ratio （E/A）, ratio of early and late diastolic myocardial motionspeed of mitral valve ring （Em/Am） .Peak systolic strain in longitudinal （LPSS）and radial （GSR）in the inner and outer layers ofmyocardium were measured in the left ventricular long-axis and short-axis views by speckle tracking imanging.The differences ofabove parameters between the two groups were compared.Results Compared with the control group, the clearance rate ofendogenous creatinine was significantly reduced in the observation group, and the levels of blood urea nitrogen, plasma non-protein nitrogen and blood creatinine were significantly increased （all P〈0.05） .There were no statistically significant differences ofIVSTd, LVPWd, LVDd, LVDs, and LVEF between the two groups.E/A and Em/Am in the observation group were significantlyreduced compared with those in the control group （all P〈0.05） .LPSS of the left ventricular basal segment, middle segment, apical segment and the whole endocardial layerwere significantly increased compared with that of the epicardial layer in the control group（all P〈0.05） .There was no significant difference between the endocardium and epicardial LPSS of each segment an

关 键 词：斑点追踪成像 糖尿病 肾功能不全 收缩功能 心室 左 

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