二维斑点追踪成像技术对单纯及合并冠心病或高血压的2型糖尿病患者左心室功能的评估价值  

The value of evaluating the left ventricular function in type 2 diabetes mellitus patients with or without hypertension or coronary heart disease by two-dimensional speckle tracking imaging

作　　者：欧阳晓光 丁玉琼 OU-YANG Xiao-guang;DING Yu-qiong(Zhongda Huiya Hospital,Huizhou 516081,China)

机构地区：[1]惠州市中大惠亚医院,516081

出　　处：《中国实用医药》2023年第13期68-71,共4页China Practical Medicine

基　　金：广东省惠州市科技计划项目(项目编号:2020Y399)。

摘　　要：目的 探讨二维斑点追踪成像(2D-STI)技术对单纯及合并冠心病或高血压的2型糖尿病患者左心室收缩及舒张功能的评估价值。方法 选取65例2型糖尿病患者,其中25例单纯2型糖尿病患者归为单纯糖尿病组,20例合并高血压患者归为糖尿病合并高血压组,20例合并冠心病患者归为糖尿病合并冠心病组;另选取25例健康人群为对照组。采用2D-STI技术测量左心室基底段、中间段、心尖段以及整体纵向应变。比较四组常规超声测量参数[左心室射血分数(LVEF)、左心房内径(LAD)、室间隔厚度(IVS)、左心室后壁厚度(LVPW)、二尖瓣口舒张早期与晚期血流峰值速度比值(E/A)、二尖瓣口舒张早期血流峰值速度与二尖瓣环侧壁舒张早期血流峰值速度比值(E/e’)]、左心室整体纵向峰值应变(GLS)、舒张早期峰值应变率。结果 四组LVEF比较,差异无统计学意义(P>0.05)。对照组LAD、E/e’分别为(32.8±4.3)mm、(7.32±2.16),小于单纯糖尿病组的(37.8±4.2)mm、(10.49±3.22),糖尿病合并冠心病组的(38.1±3.9)mm、(11.32±2.86)及糖尿病合并高血压组的(38.3±4.1)mm、(10.81±3.17),差异有统计学意义(P<0.05)。对照组E/A(1.21±0.38)大于单纯糖尿病组的(0.83±0.28)、糖尿病合并冠心病组的(0.81±0.25)、糖尿病合并高血压组的(0.76±0.23),差异有统计学意义(P<0.05)。糖尿病合并高血压组IVS、LVPW分别为(11.21±1.17)、(11.32±0.95)mm,大于对照组的(8.73±0.92)、(8.68±0.84)mm,单纯糖尿病组的(9.11±1.04)、(8.91±0.94)mm及糖尿病合并冠心病组的(9.31±1.07)、(9.02±1.21)mm,差异有统计学意义(P<0.05)。单纯糖尿病组、糖尿病合并冠心病组、糖尿病合并高血压组GLS绝对值均低于对照组,且糖尿病合并冠心病组、糖尿病合并高血压组GLS绝对值低于单纯糖尿病组,差异有统计学意义(P<0.05)。单纯糖尿病组、糖尿病合并冠心病组、糖尿病合并高血压组舒张早期峰值应变率低�Objective To discuss the left ventricular systolic and diastolic function of type 2 diabetes patients with simple coronary heart disease or hypertension by two-dimensional speckle tracking imaging(2D-STI).Methods 65 patients with type 2 diabetes mellitus were selected,of which 25 patients with type 2 diabetes mellitus alone as the diabetes mellitus group,20 patients combined with hypertension as the diabetes mellitus with hypertension group,and 20 patients combined with heart disease as the diabetes mellitus with coronary heart disease group;another 25 healthy subjects were selected as the control group.The longitudinal strain of basal,middle and apex segments as well as the whole left ventricle were measured by 2D-STI.Comparison was made on conventional ultrasound measurement parameters[left ventricular ejection fraction(LVEF),left atrial diameter(LAD),interventricular septum(IVS),left ventricular posterior wall thickness(LVPW),the ratio of early transmitral flow velocity to the ratio of later transmitral flow velocity(E/A),ratio of early diastolic transmitral flow velocity to early mitral annular velocity(E/e')],global longitudinal strain(GLS),and early diastolic peak strain rate among the four groups.Results The differences were not statistically significant when comparing the LVEF of the four groups(P>0.05).LAD and E/e'were(32.8±4.3)mm and(7.32±2.16)in the control group,which were less than those in diabetes mellitus group[(37.8±4.2)mm and(10.49±3.22)],diabetes mellitus with coronary artery disease group[(38.1±3.9)mm and(11.32±2.86)],and diabetes mellitus with hypertension group[(38.3±4.1)mm and(10.81±3.17)].The differences were statistically significant(P<0.05).E/A of(1.21±0.38)in the control group was greater than that of(0.83±0.28)in diabetes mellitus group,(0.81±0.25)in diabetes mellitus with coronary artery disease group,and(0.76±0.23)in diabetes mellitus with hypertension group.The differences were statistically significant(P<0.05).IVS and LVPW were(11.21±1.17)and(11.32±0.95)mm in diabetes

关 键 词：2型糖尿病 二维斑点追踪成像 左心室功能 

分 类 号：R541.4[医药卫生—心血管疾病]