三维斑点追踪成像评价代谢因素对2型糖尿病患者左室结构和功能的影响  

Association of metabolic factors with left ventricular structure and function in type 2 diabetic patients:A 3D speckle tracking imaging study

作　　者：梁丽媚 刘红利 张会欣[1] 何鑫 赵世光[1] LIANG Limei;LIU Hongli;ZHANG Huixin;HE Xin;ZHAO Shiguang(Department of Function,Shijiazhuang Second Hospital,Shijiazhuang,050051,China;Department of Traditional Chinese Medicine Glycuresis,Shijiazhuang Second Hospital)

机构地区：[1]河北省石家庄市第二医院功能科,石家庄050051 [2]河北省石家庄市第二医院糖尿病中医科

出　　处：《临床心血管病杂志》2021年第12期1111-1116,共6页Journal of Clinical Cardiology

基　　金：国家重点研发计划(No:2017YFC1700501);河北省中医药管理局项目(No:2022488)。

摘　　要：目的:应用常规超声心动图和三维斑点追踪成像评价2型糖尿病(T2DM)患者的左室结构和功能,探讨代谢因素如何影响左室的结构和功能。方法:150例接受治疗的T2DM患者,按照代谢因素控制的情况分为DM1组(0个代谢因素控制不佳,35例)、DM2组(1~2个代谢因素控制不佳,62例)、DM3组(≥3个代谢因素控制不佳,53例)。另选取40例健康志愿者作为对照组。入组者进行常规超声心动图和三维斑点追踪成像检查,获取常规超声测量值和左室整体纵向应变(GLS)、整体圆周应变(GCS)、整体面积应变(GAS)和整体径向应变(GRS)。结果:与对照组比较,DM1组的e’、E/A减小(均P<0.05),E、E/e’增大(均P<0.05);DM2组的相对室壁厚度(RWT)增加(P<0.05),DM3组的RWT及左室质量指数(LVMI)均明显增加(均P<0.05);DM2组的GLS降低(P<0.05),DM3组的GLS、GCS、GAS、GRS均明显降低(均P<0.05)。多元线性回归分析显示,BMI与左室GLS、GCS、GAS、GRS(β=-0.183、-0.278、-0.258、-0.312,均P<0.05)存在明显的相关性。结论:在T2DM患者中,代谢因素控制良好者仅有左室舒张功能降低;代谢因素控制不佳的负荷增加与左室重构和收缩功能降低有关。Objective:To evaluate the left ventricular structure and function in type 2 diabetes mellitus using three-dimensional speckle tracking imaging and to study how metabolic factors impact left ventricular structure and function.Methods:A total of 150 patients with type 2 diabetes with different degrees of metabolic factors were divided into 3 groups:DM1 group(0 poor controlled metabolic factors,n=35),DM2 group(1-2 poor controlled metabolic factors,n=62),and DM3 group(≥3 poor controlled metabolic factors,n=53).Other 40 healthy volunteers served as controls.Conventional echocardiography and three-dimensional speckle tracking imaging were performed.Conventional echocardiographic measurements and left ventricular global longitudinal strain(GLS),global circumferential strain(GCS),global area strain(GAS),and global radial strain(GRS)were obtained.Results:Compared to the control group,e’and E/A were decreased,while E and E/e’were increased in the DM1 group(all P<0.05),the relative wall thickness(RWT)was increased in the DM2 group(P<0.05),the RWT and left ventricular mass index(LVMI)were significantly increased in the DM3 group(all P<0.05),GLS was decreased in the DM2 group(P<0.05),while GLS,GCS,GAS,and GRS were significantly decreased in the DM3 group(all P<0.05).Multivariable linear regression indicated that BMI was independently associated with GLS,GCS,GAS,and GRS(β=-0.183,-0.278,-0.258,-0.312,all P<0.05).Conclusion:In patients with type 2 diabetes,only left ventricular diastolic function impaired in patients with metabolic factors are well controlled.The increasing burden of poor controlled metabolic factors is associated with structural and functional impairments.

关 键 词：三维斑点追踪 左室功能 2型糖尿病 代谢 

分 类 号：R542.2[医药卫生—心血管疾病]