压力-应变环评价2型糖尿病患者左心室心肌做功改变  

Evaluation of Left Ventricular Myocardial Work Changes in Patients with Type 2 Diabetes by Using Pressure-Strain Loop

作　　者：王一洒[1] 袁建军[1] 朱好辉[1] 张苗 丁晓[1] 魏常华[1] WANG Yisa;YUAN Jianjun;ZHU Haohui;ZHANG Miao;DING Xiao;WEI Changhua(Department of Ultrasound,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院超声科,河南郑州450003

出　　处：《中国医学影像学杂志》2020年第12期934-937,共4页Chinese Journal of Medical Imaging

基　　金：河南省医学科技攻关计划(201702189)。

摘　　要：目的应用压力-应变环定量评估2型糖尿病患者左心室心肌做功情况。资料与方法37例2型糖尿病患者和34例正常对照者进行常规超声心动图测量,存储3个心尖长轴切面各3个心动周期的动态图像,测量肱动脉压,于EchoPAC工作站进行描记分析,根据患者血压绘制压力-应变曲线,并计算左心室整体纵向应变(GLS)、整体做功指数(GWI)、整体有效功(GCW)、整体无效功(GWW)及整体做功效率(GWE)。结果糖尿病组患者年龄、体重指数、收缩压、舒张压与对照组比较,差异均无统计学意义(P>0.05);两组空腹血糖差异有统计学意义(P<0.05)。两组常规超声心动图测量参数左心房内径、左心室舒张末期内径、舒张末期室间隔厚度、舒张期左心室后壁厚度、左心室射血分数比较,差异均无统计学意义(P>0.05)。糖尿病组GLS[(-18.4±2.0)%比(-22.1±2.4)%]、GWI[(1770±249)mmHg%比(2099±232)mmHg%]、GCW[(2053±299)mmHg%比(2403±278)mmHg%]低于对照组(P<0.05),两组GWW及GWE比较差异无统计学意义(P>0.05)。结论左心室压力-应变环可以定量评估早期2型糖尿病患者的左心室心肌做功改变,对评价左心室收缩功能改变具有一定的临床意义。Purpose To quantitatively evaluate the left ventricular myocardial work in patients with type 2 diabetes by pressure-strain loop.Materials and Methods Thirty-seven patients with type 2 diabetes and 34 normal controls were measured by conventional echocardiography,and dynamic images of three cardiac cycles of three apical long axis sections were stored,and the brachial artery pressure was measured.A tracing analysis was conducted on EchoPAC software after storing the two-dimensional dynamic images.The pressure-strain loop curve was drawn according to the patients'blood pressure,then the left ventricular global longitudinal strain(GLS),global myocardial work index(GWI),global constructive work(GCW),global wasted work(GWW)and global myocardial work efficiency(GWE)were also calculated.Results No significant difference in age,body mass index,systolic blood pressure and diastolic blood pressure was observed between diabetes group and control group(P>0.05).The difference of fasting blood glucose was significant between the above two groups(P<0.05).There was no significant difference in conventional echocardiographic measurements left atrial diameter,left ventricular diastolic diameter,interventricular septal depth,left ventricular posterior wall depth and left ventricular ejection fraction between the two groups(P>0.05).The diabetes group showed lower levels of GLS[(-18.4±2.0)%vs.(-22.1±2.4)%],GWI[(1770±249)mmHg%vs.(2099±232)mmHg%]and GCW[(2053±299)mmHg%vs.(2403±278)mmHg%]than those of the control group(all P<0.05),no statistical difference in GWW and GWE was observed between the diabetes group and the control group.Conclusion Left ventricular pressure-strain loop can quantitatively evaluate the changes in left ventricular myocardial work of patients with early type 2 diabetes,and it has certain clinical significance in evaluating the changes in left ventricular systolic function.

关 键 词：糖尿病 2型 心室功能 左 心肌 压力-应变环 

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