三维斑点追踪技术在2型糖尿病患者左心室功能评价中的应用效果  

Application effect of 3D-STI in the evaluation of left ventricular function in patients with type 2 diabetes

作　　者：徐乐 温德惠[1] 郑英娟[1] 史宝林[2] 刘伟亮[1] 谷君[3] XU Le;WEN Dehui;ZHENG Yingjuan;SHI Baolin;LIU Weiliang;GU Jun(Department of Ultrasound,the First Affiliated Hospital of Hebei North College,Hebei Province,Zhangjiakou 075000,China;Public Health Teaching and Research Section,Hebei North College,Hebei Province,Zhangjiakou 075000,China;Department of Endocrinology,the First Affiliated Hospital of Hebei North College,Hebei Province,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院超声科,河北张家口075000 [2]河北北方学院公共卫生教研室,河北张家口075000 [3]河北北方学院附属第一医院内分泌科,河北张家口075000

出　　处：《中国医药导报》2019年第21期177-180,F0004,共5页China Medical Herald

基　　金：河北省科技计划项目(17277772D)

摘　　要：目的探讨三维斑点追踪技术(3D-STI)在2型糖尿病患者左心室功能评价中的应用效果。方法选取2017年1月~2018年4月河北北方学院附属第一医院(以下简称“我院”)2型糖尿病患者81例,根据颈总动脉内-中膜厚度(IMT)是否增厚分为TM1组(IMT≤1.0mm)(n=38)及TM2组(1.0mm<IMT<1.2mm)(n=43);选择我院同期年龄和性别匹配的健康者作为对照组(n=40)。比较各组左室整体纵向应变(GLS)、圆周应变(GCS)、面积应变(GAS)及径向应变(GRS)、左室射血分数、颈动脉IMT及相关临床指标,分析各应变值与IMT及糖化血红蛋白(HbA1c)的相关性。结果与对照组比较,TM1组GLS降低,差异有统计学意义(P<0.05);分别与对照组及TM1组比较,TM2组GLS、GCS、GAS及GRS显著降低(P<0.01或P<0.05);IMT及HbA1c与左室各个方向的应变均呈负相关(r<0,P<0.05)。结论2型糖尿病患者早期的亚临床左室功能障碍可通过3D-STI发现,如合并颈动脉IMT增厚,则左室收缩功能进一步损伤,左室射血分数降低,3D-STI是发现这些轻微异常的敏感方法。Objective To investigate the application effect of three-dimensional speckle tracking technology(3D-STI)in the evaluation of left ventricular function in patients with type 2 diabetes mellitus.Methods From January 2017 to April 2018,81 patients with type 2 diabetes mellitus from the First Affiliated Hospital of Hebei North University("our hospital"for short)were selected.According to whether the intima-media thickness(IMT)of the common carotid artery was thickened,it was divided into TM1 group(IMT≤1.0 mm)(n=38)and TM2 group(1.0 mm<IMT<1.2 mm)(n=43),and healthy subjects with matched age and gender in the same period in our hospital were selected as the control group(n=40).Left ventricular global longitudinal strain(GLS),circumferential strain(GCS),area strain(GAS),radial strain(GRS),left ventricular ejection fraction(LVEF),carotid IMT and related clinical indicators were compared in each group,and the correlation between strain values and IMT and glycated hemoglobin(HbA1c)was analyzed.Results Compared with the control group,GLS in TM1 group decreased,and the difference was statisticlly significant(P<0.05).Compared with the control group and the TMI group,GLS,GCS,GAS and GRS in TM2 group decreased significantly(P<0.01 or P<0.05),IMT and HbA1c were negatively correlated with left ventricular strain in all directions(r<0,P<0.05).Conclusion Subclinical left ventricular dysfunction in early stage of type 2 diabetes mellitus can be detected by 3D-STI.If carotid IMT thickening occurs,left ventricular systolic function will be further impaired and left ventricular ejection fraction will be reduced.3D-STI is a sensitive method to detect these slight abnormalities.

关 键 词：三维斑点追踪技术 糖尿病 左心室功能 

分 类 号：R587.1[医药卫生—内分泌]