左心室压力-应变环评价老年高血压合并/不合并2型糖尿病的心肌做功  

Evaluation of Myocardial Work in Elderly Hhypertension Patients with/without Type 2 Diabetes by Left Ventricular Pressure-strain Ring

作　　者：张佳宇 康春松[2] 胡钰青 Zhang Jiayu;Kang Chunsong;Hu Yuqing(Medical Imaging Department of Shanxi Medical University,Taiyuan 030001,China;Department of Ultrasound,Shanxi Bethune Hospital Affiliated to Shanxi Medical University,Taiyuan 030032,China)

机构地区：[1]山西医科大学医学影像学院,太原市030001 [2]山西医科大学附属山西白求恩医院超声科,太原市030032

出　　处：《中国超声医学杂志》2023年第3期277-281,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 应用无创左心室压力-应变环(PSL)评估老年高血压患者合并/不合并2型糖尿病(T2DM)时的左心室心肌功能。方法 选取124例老年高血压患者,依据是否合并糖尿病,分为高血压血糖正常组68例,高血压合并糖尿病组56例;另选取64名健康老年人为对照组。应用二维斑点追踪超声心动图获取左心室心肌整体纵向应变(GLS),根据左心室PSL测量心肌做功(MW)参数,包括整体做功指数(GWI)、整体有效功(GCW)、整体无效功(GWW)、整体做功效率(GWE),并进行比较分析。结果 与对照组比较,高血压各组左心室GLS均减小,GCW、GWI、 GWW均增大,高血压血糖正常组GWE降低,差异均有统计学意义(P<0.05)。高血压合并糖尿病组GWE与对照组无明显差异(P>0.05)。与高血压血糖正常组相比,高血压合并糖尿病组的GLS、GCW、GWI降低,差异均有统计学意义(P<0.05);而两高血压组GWW差异无统计学意义(P>0.05)。结论 糖尿病会加重老年高血压患者左心室心肌功能障碍,左心室压力-应变环可以准确、全面评估合并糖尿病的高血压患者的左心室心肌功能,具有重要的临床价值。Objective To estimate left ventricular myocardial function in elderly hypertensive patients with/without type 2 diabetes mellitus(T2DM) by applying non-invasive left ventricular pressure-strain loop(PSL). Methods A total of 124 elderly patients with hypertension were selected and divided into two groups according to whether they had diabetes mellitus: hypertensive with normal blood glucose group(n=68) and hypertension with diabetes mellitus group(n=56). Another 64 healthy elderly patients were selected as the control group. Left ventricular global longitudinal strain(GLS) was determined by two-dimensional speckle tracking echocardiography. Myocardial work(MW) parameters were measured according to left ventricular PSL, including global work index(GWI), global effective work(GCW), global ineffective work(GWW), and global work efficiency(GWE). Results Compared with the control group, the left ventricular GLS decreased and GCW, GWI, and GWW increased in the each hypertensive group, while GWE decreased in the hypertensive with normal blood glucose group(P<0.05). There was no significant difference in GWE between hypertension with diabetes mellitus group and control group(P>0.05). Compared with hypertensive with normal blood glucose group, the GLS, GCW, and GWI of the hypertensive with diabetes mellitus group were significantly reduced(P<0.05). There was no significant difference in GWW between the two hypertensive groups(P>0.05). Conclusions Diabetes can aggravate left ventricular myocardial dysfunction in elderly hypertensive patients. Left ventricular PSL can accurately and comprehensively evaluate left ventricular myocardial function in hypertensive patients with diabetes, which has important clinical value.

关 键 词：高血压 糖尿病 压力-应变环 心肌做功 

分 类 号：R445.1[医药卫生—影像医学与核医学] R544.1[医药卫生—诊断学] R587.1[医药卫生—临床医学]