超声心动图评价2型糖尿病患者的左心室重构和功能损害  

Evaluation of Left Ventricular Remodeling and Accompanied Dysfunction by Echocardiography in Type 2 Diabetic Patients

作　　者：王庆庆 马雯妍 夏纪筑 李明星 范英 Wang Qingqing;Ma Wenyan;Xia Jizhu;Li Mingxing;Fan Ying(Department of Ultrasound,Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China)

机构地区：[1]西南医科大学附属医院超声科,四川省泸州市646000

出　　处：《中国超声医学杂志》2020年第2期122-124,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的联合运用常规超声心动图和三维斑点追踪成像技术评价不同左室构型的2型糖尿病患者心脏功能的损害情况。方法78例2型糖尿病患者(LVEF≥55%)分为左室正常构型组(34例)和左室重构组(44例)。40例年龄、性别匹配且无左室重构的健康体检者作为对照组。采集左心室全容积图像分析,计算射血分数(EF)、整体纵向应变(GLS)、圆周应变(GCS)、面积应变(GAS)和径向应变(GRS)。结果糖尿病左室正常构型组仅有GLS显著低于对照组(P<0.05);而糖尿病左室重构组GLS、GCS、GAS和GRS均显著低于对照组和糖尿病左室正常构型组(all P<0.01)。糖尿病左室肥厚组(向心性和离心性)的GLS、GAS和GRS显著低于糖尿病左室向心性重构组(all P<0.05)。结论常规超声心动图和三维斑点追踪成像联合运用可以检测出2型糖尿病患者的左心室代谢性重构和伴随的功能损害。Objective To use conventional echocardiography and three-dimensional speckle-tracking imaging(3DSTI)to evaluate the cardiac functional damages in type 2 diabetic patients with different LV geometry.Methods Seventy-eight T2DM patients were divided into two groups with LV normal geometry(LVN,n=34)and with LV remodeling(LVR,n=44).Forty age-and gender-matched healthy volunteers without LVR were recruited as the controls.The LV full-volume images were recorded and analyzed.The ejection fraction(EF),global longitudinal strain(GLS),global circumferential strain(GCS),global area strain(GAS)and global radial strain(GRS)were calculated.Results The T2DM patients with LVN showed significantly lower GLS than the controls(P<0.05),whereas the T2DM patients with LVR showed significantly lower GLS,GCS,GAS,and GRS than the controls and the T2DM patients with LVN(all P<0.01).Additionally,GLS,GAS,and GRS decreased significantly in the T2DM patients with LV hypertrophy(both concentric and eccentric)than in those with LV concentric remodeling(all P<0.05).Conclusions The combination of conventional echocardiography and 3DSTI could detect the metabolic LV remodeling and accompanied dysfunction in T2DM patients.

关 键 词：三维斑点追踪成像 2型糖尿病 左室重构 左室功能 

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