三维斑点追踪技术对T2DM合并高脂血症患者亚临床左心室收缩功能障碍的研究  

Three-dimensional speckle tracking for subclinical left ventricular systolic dysfunction in patients with type 2 diabetes mellitus and hyperlipidemia

作　　者：武鹏[1] 郝长生[1] 周瑞君[1] 常丽[1] 王逸男 李亚楠 Wu Peng;Hao Changsheng;Zhou Ruijun;Chang Li;Wang Yinan;Li Yanan(Department of Ultrasound,Heji Hospital Affiliated to Changzhi Medical College,Changzhi 046000,Shanxi Province,China)

机构地区：[1]长治医学院附属和济医院超声科,长治046000

出　　处：《中国基层医药》2023年第2期258-264,共7页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的:探讨2型糖尿病(T2DM)合并/不合并高脂血症患者左心功能障碍的差别,并探索三维斑点追踪技术(3D-STE)在其中的应用价值。方法:回顾性分析长治医学院附属和济医院2020年1月至2021年6月收治的T2DM患者70例的临床资料,其中合并高脂血症35例,不合并高脂血症35例。同时选取同时间段健康体检者40例为对照组。均完善常规心脏超声和3D-STE检查。比较对照组与T2DM合并/不合并高脂血症患者一般临床信息和左心功能相关参数,包括整体纵向应变(global longitudinal strain,GLS)、整体圆周应变(global circumferential strain,GCS)、整体面积应变(global area strain,GAS)和整体径向应变(global radial strain,GRS)等。结果:T2DM不合并高脂血症组的左室重构比例增高,而T2DM合并高脂血症组的左室肥大比例最高。T2DM不合并高脂血症组的GLS[(-16.97±2.59)%]和GCS[(-17.41±2.50)%]均显著高于对照组[(-18.86±2.46)%、(-18.71±2.92)%](t=0.95、0.57,均P<0.05)。T2DM合并高脂血症组的GLS[(-14.98±3.15)%]、GCS[(-15.80±3.16)%]、GAS[(-27.17±4.54)%]均显著高于对照组[(-18.86±2.46)%、(-18.71±2.92)%、(-30.62±4.02)%](t=0.46、1.37、0.98,P<0.05)和T2DM不合并高脂血症组[(-16.97±2.59)%、(-17.41±2.50)%、(-30.06±3.59)%](t=0.37、1.02、0.77,均P<0.05),GRS[(41.85±9.25)%]显著低于对照组[(51.49±8.94)%](t=1.35,P<0.05)和T2DM不合并高脂血症组[(47.71±8.46)%](t=0.98,P<0.05)。在T2DM患者中,空腹血糖和高脂血症均与所有应变相关参数值独立相关。结论:高脂血症可进一步加重T2DM患者的左室重构和功能障碍,3D-STE是T2DM合并或不合并高脂血症患者的亚临床左室重构及功能异常的检查方法之一。Objective:To investigate the difference in left ventricular dysfunction between type 2 diabetes mellitus(T2DM)patients with hyperlipidemia and those without hyperlipidemia,and analyze the application value of three-dimensional speckle tracking technology.Methods:The clinical data of 70 patients with T2DM admitted to Heji Hospital Affiliated to Changzhi Medical College from January 2020 to June 2021 were retrospectively analyzed.Among these patients,35 patients had hyperlipidemia and 35 patients had no hyperlipidemia.At the same time,40 healthy subjects who concurrently underwent health checkups in the same hospital were included as healthy controls.All subjects underwent routine cardiac ultrasound and 3D-STE examinations.General clinical information and left ventricular function-related parameters,including global longitudinal strain,global circumferential strain,global area strain,and global radial strain were compared between healthy controls and T2DM patients with hyperlipidemia and those without hyperlipidemia.Results:The proportion of left ventricular remodeling increased in T2DM patients without hyperlipidemia,and the proportion of left ventricular hypertrophy was the highest in T2DM patients with hyperlipidemia.Global longitudinal strain and global circumferential strain in T2DM patients without hyperlipidemia were(-16.97±2.59)%and(-17.41±2.50)%,respectively,which were significantly higher than(-18.86±2.46)%and(-18.71±2.92)%in healthy controls(t=0.95,0.57,both P<0.05).Global longitudinal strain,global circumferential strain,and global area strain in T2DM patients with hyperlipidemia were(-14.98±3.15)%,(-15.80±3.16)%,(-27.17±4.54)%,respectively,which were significantly higher than(-18.86±2.46)%,(-18.71±2.92)%,(-30.62±4.02)%in healthy controls(t=0.46,1.37,0.98,all P<0.05)and(-16.97±2.59)%,(-17.41±2.50)%,(-30.06±3.59)%in T2DM patients without hyperlipidemia(t=0.37,1.02,0.77,all P<0.05).Global radial strain in T2DM patients with hyperlipidemia was significantly higher than[(51.49±8.94)%,t=1.35,P<

关 键 词：超声心动描记术 成像 三维 糖尿病 2型 高脂血症 心室功能 左 心室重构 危险因素 并发症 

分 类 号：R587.2[医药卫生—内分泌] R589.2[医药卫生—内科学]