斑点追踪分层应变技术评估急性冠状动脉综合征合并糖尿病患者左室心肌分层应变及其与甘油三酯葡萄糖指数的相关性  

Evaluation of left ventricular myocardial layer strain in patients with acute coronary syndrome combined with diabetes mellitus by speckle tracking layer strain and its correlation with triglyceride glucose index

作　　者：刘家佳 张璐[2] 张艳[2] 杨梦琪 薛丽丽[3] 邓爱云[2] LIU Jiajia;ZHANG Lu;ZHANG Yan;YANG Mengqi;XUE Lili;DENG Aiyun(the First Clinical Medical College of Lanzhou University,Lanzhou 730000,China;不详)

机构地区：[1]兰州大学第一临床医学院,兰州市730000 [2]兰州大学第一医院心内超声室 [3]兰州大学第一医院超声医学科

出　　处：《临床超声医学杂志》2023年第6期423-429,共7页Journal of Clinical Ultrasound in Medicine

基　　金：甘肃省自然科学基金项目(20JR10RA679);兰大一院院内基金项目(ldyyyn2019-63)。

摘　　要：目的应用斑点追踪分层应变技术评价急性冠状动脉综合征(ACS)合并糖尿病(DM)患者左室心肌分层应变,分析甘油三酯葡萄糖(TyG)指数与分层应变参数的相关性。方法选取我院ACS并行冠状动脉造影的患者76例,根据是否合并DM分为单纯ACS组和ACS合并DM组,每组各38例,另选同期健康体检者22例为对照组。应用常规超声心动图测量左室射血分数(LVEF)、左室舒张末期内径(LVEDD);斑点追踪分层应变技术分别测量左室心内膜下、中层、心外膜下心肌整体纵向应变(GLSendo、GLSmid、GLSepi);实验室检查获取TyG指数,比较各组上述参数的差异。采用Pearson相关分析法、岭回归分析法分析TyG指数与GLSendo、GLSmid、GLSepi的相关性;同时分析观察者间和观察者内测量心肌分层应变参数的一致性。结果与单纯ACS组和对照组比较,ACS合并DM组TyG指数明显升高(均P<0.05)。与对照组比较,单纯ACS组GLSendo及ACS合并DM组LVEF、LVEDD、GLSendo、GLSmid、GLSepi均减低(均P<0.05);与单纯ACS组比较,ACS合并DM组LVEDD、GLSendo、GLSmid、GLSepi均减低(均P<0.05)。相关性分析和岭回归分析显示TyG指数与GLSendo、GLSmid、GLSepi均呈正相关,回归方程为:Y=0.432+0.185X1+0.321X2+0.456X3,Y为TyG指数,X1、X2、X3分别为GLSendo、GLSmid、GLSepi。一致性分析显示,观察者间和观察者内测量GLSendo、GLSmid、GLSepi的一致性均良好(组内相关系数均>0.8)。结论应用斑点追踪分层应变技术可以定量评估ACS合并DM患者左室心肌分层应变,且TyG指数与分层应变参数具有相关性。Objective To evaluate the left ventricular myocardial layer strain in patients with acute coronary syndrome(ACS)combined with diabetes mellitus(DM)by speckle tracking layer strain(STLS)technique,and to analyze the correlation between triglyceride glucose(TyG)index and layer strain parameters.Methods A total of 76 patients with ACS who underwent coronary angiography in our hospital were selected and divided into two groups:ACS without DM group(38 cases)and ACS with DM group(38 cases).Additionally,22 healthy individuals who underwent physical examination during the same period were selected as the control group.The left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)were measured by conventional echocardiography.The overall longitudinal strain of the left ventricular endocardial,middle and epicardial layers(GLSendo,GLSmid,GLSepi)were measured by STLS technology,and the TyG index of each group was obtained by laboratory examination.The above parameters of each group were compared.Pearson correlation analysis and ridge regression analysis were used to analyze the correlation between TyG index and GLSendo,GLSmid,GLSepi.The consistency of layer strain parameters measured between observers and within observers was also analyzed.Results Compared with the ACS without DM group and the control group,the TyG index in the ACS with DM group was significant increased(P<0.05).Compared with the control group,the GLSendo in the ACS without DM group was decreased,while the LVEF,LVEDD,GLSendo,GLSmid and GLSepi in the ACS with DM group were also decreased(all P<0.05).Correlation analysis and ridge regression analysis showed that TyG index was positively correlated with GLSendo,GLSmid,and GLSepi.The regression equation was as follows:Y=0.432+0.185X1+0.321X2+0.456X3,Y was the TyG index,X1,X2 and X3 were GLSendo,GLSmid,and GLSepi,respectively.The consistency analysis showed good consistency of GLSendo,GLSmid and GLSepi between observers and within observers(intraclass correlation coefficients were all>

关 键 词：超声心动描记术 斑点追踪 分层应变 冠状动脉综合征 急性 糖尿病 甘油三酯葡萄糖指数 

分 类 号：R540.45[医药卫生—心血管疾病]