二维斑点技术评价糖尿病患者的心肌收缩功能和同步性  

Evaluation of Myocardial Systolic Function and Synchrony in Patients with Diabetes by Two-Dimensional Speckle Technique

作　　者：蒋媛媛[1] 葛艳[1] 黄美蓉[1] 徐洋[2] JIANG Yuanyuan;GE Yan;HUANG Meirong;XU Yang(Department of Ultrasound,the First Affiliated Hospital of Xiamen University,Xiamen 361000,China;Medical Beauty Department,Siming Branch of the First Affiliated Hospital of Xiamen University,Xiamen 361000,China)

机构地区：[1]厦门大学附属第一医院超声科,福建厦门361000 [2]厦门大学附属第一医院思明分院医疗美容科,福建厦门361000

出　　处：《中国医药指南》2023年第4期14-19,共6页Guide of China Medicine

摘　　要：目的 探讨二维斑点技术评价糖尿病患者的心肌收缩功能和同步性。方法 从本院收治的糖尿病患者选择40例,并选取同期38名健康者为本次的研究对象,所有人使用二维斑点超声技术,获取心尖四腔观、两腔观、左室长轴观图像,各水平段的左室短轴观图像,并对内膜下及外膜下心肌收缩期的纵向、圆周向、径向峰值应变,左心室收缩同步性进行测定。结果 两组的LVEDD、LVESD、LVFS、IVSd、PWd、LVEF、二尖瓣E峰值、二尖瓣A峰值、E/A等常规超声心动图指标均有差异,但差异无统计学意义(P> 0.05)。左室长轴内膜下心肌收缩期纵向峰值应变中,研究组与对照组相比显著更低(P <0.05);外膜下心肌收缩期纵向峰值应变中,后壁、下壁及后间隔显著更低(P <0.05)。研究组的基底段内外膜下、中间段内外膜下、心尖段内外膜下左室短轴心肌收缩期圆周向峰值应变较对照组显著更低(P <0.05),尤其是基底段、中间段内膜下降低更明显(P <0.05)。两组的左室短轴心肌收缩期径向峰值应变均差异无统计学意义(P> 0.05)。对照组的心底水平旋转曲线波形为负向,心尖水平为正向,曲线较规律,水平旋转角度均匀大于心底水平,心底水平下壁、后室间隔较大;左心室扭转曲线波形为正向,下壁、后室间隔、后壁较其他更大。研究组心底水平旋转曲线波形为负向,心尖水平波形为正向,左心室扭转波形为正向,呈无规律变化。研究组的心底水平侧壁、前室间隔与对照组差异无统计学意义(P> 0.05),其他各室壁各平面旋转角度、左心室局部及整体扭转角度较对照组有显著减小(P <0.05)。糖尿病组Tsl-SD、Tsl-diff、Tsc-SD明显大于对照组(P <0.05);短轴径向、扭转时间参数较对照组稍大,但差异无统计学意义(P> 0.05)。结论 二维斑点技术能发现常规超声心动图中无法发现的左心室早期心肌收缩功能异常情况,表现为纵向�Objective To explore the evaluation of myocardial systolic function and synchronization in patients with diabetes by two-dimensional speckle technique. Methods A total of 40 patients with diabetes were selected from our hospital, and 38 healthy people in the same period were selected as the research objects. All of them used two-dimensional speckle ultrasound technology to obtain apical four chamber view, two chamber view, left ventricular long axis view images, and left ventricular short axis view images of each horizontal segment. The longitudinal, circumferential, radial peak strains and left ventricular systolic synchrony of subintimal and sub adventitial myocardium were measured. Results There were differences in LVEDD, LVESD, lvfs,IVSd, PWd, LVEF, mitral E peak, mitral a peak, E/A and other conventional echocardiographic indexes between the two groups, but the difference was not significant(P>0.05). Compared with the control group, the longitudinal peak systolic strain of left ventricular long axis subendocardium in the study group was significantly lower(P<0.05). In the longitudinal peak systolic strain of subadventitia myocardium, the posterior wall, inferior wall and posterior septum were significantly lower(P<0.05). The circumferential peak strain of left ventricular short axis myocardium in the study group was significantly lower than that in the control group(P<0.05), especially in the basement and middle segments(P<0.05). There was no significant difference in left ventricular short axis myocardial systolic peak strain between the two groups(P>0.05). In the control group, the wave shape of the horizontal rotation curve of the cardiac fundus was negative, the apical level was positive, the curve was regular, the horizontal rotation angle was even greater than that of the cardiac fundus level, and the inferior wall and posterior ventricular septum of the cardiac fundus level were larger;the waveform of left ventricular torsion curve is positive, and the inferior wall, posterior ventricular septum and p

关 键 词：糖尿病 斑点超声 同步性 心肌收缩 

分 类 号：R587.1[医药卫生—内分泌]