超声二维斑点追踪联合实时三维超声心动图评价2型糖尿病患者左心功能  

Assessment of left heart function in patients with type 2 diabetes using two-dimensional speckle tracking imaging integrated with real-time three-dimensional echocardiography

作　　者：李秀云[1] 吴道珠[1] 刘咏芳[1] 肖莉莉[1] 王亮[1] LI Xiuyun;WU Daozhu;LIU Yongfang;XIAO Lili;WANG Liang(Department of Ultrasound,the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University,Wenzhou 325027,Zhejiang,China)

机构地区：[1]温州医科大学附属第二医院育英儿童医院超声科,浙江温州325027

出　　处：《中国现代医生》2023年第33期31-34,40,共5页China Modern Doctor

基　　金：浙江省温州市基础性科研项目(Y2020799)。

摘　　要：目的探讨超声二维斑点追踪(two-dimensional speckle tracking imaging,2D-STI)联合实时:三维超声心动图(real-time three-dimensional echocardiography,RT-3DE)技术在评价2:型糖尿病患者左心功能的价值。方法选取2021年6月至2022年12月在温州医科大学附属第二医院、育英儿童医院诊断的2型糖尿病患者36例纳入糖尿病组,同时选取30名健康者为对照组,所有纳入者接受超声心动图检查。应用自动心脏自动量化技术分析左心室心尖四腔(four chamber,4C.)、心尖两腔(two chamber,2C)及心尖三腔(three chamber,3C)的整体纵向应变(global longitudinal strain,GLS.)曲线,获得四腔心整体纵向应变(global longitudinal strain four chamber,GLS4C)、两腔心整体纵向应变(global longitudinal strain two chamber,GLS2C)及三腔心整体纵向应变(global longitudinal strain three chamber,GLS3C)。应用3DQ advanced软件技术,手动选择左心房范围,软件自动分析生成左心房容积-时间曲线,获得左心房最大容积、左心房最小容积和收缩期前容积,所得容积参数采用体表面积进行校正,获得左心房最大容积指数、左心房最小容积指数和左心房收缩期前容积指数,并计算左心房总体射血分数、左心房被动射血分数和左心房主动射血分数,分析比较两组纳人者之间的差异。结果糖尿病组患者的左心房最大容积指数、左心房收缩期前容积指数、左心房最小容积指数均大于对照组,左心房总体射血分数、左心房被动射血分数均小于对照组(P<0.05);左心房主动射血分数在两组间的差异无统计学意义(P>0.05);糖尿病组患者的GLS4C、GLS2C及GLS3C绝对值小于对照组(P<0.05)。结论RT-3DE可用来评价糖尿病患者左心房容积和功能改变,2D-STI技术可早期评价2型糖尿病患者左心室收缩功能,两者联合应用可综合评价2型糖尿病患者的左心功能。Objective To explore the value of two-dimensional speckle tracking imaging(2D-STI)combined with real-time three-dimensional echocardiography(RT-3DE)in evaluating left heart function in patients with type 2 diabetes.Methods A total of 36 diagnosed patients with type 2 diabetes mellitus and 30 control subjects were collected from June 2021 to December 2022 in the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University,all of them underwent echocardiography examination.Left ventricular(LV)global longitudinal strain(GLS)were analysised by automated cardiac motion quantification from the views of apical four chamber(4C),two chamber(2C)and three chamber(3C),the global longitudinal strain four chamber(GLS4C),global longitudinal strain two chamber(GLS2C),and global longitudinal strain three chamber(GLS3C)were obtained.Meanwhile the software of 3DQA was used to analyze left atrium and generate the left atrial volume time curve to obtain the left atrial maximum volume,left atrial minimum volume and pre systolic volume,all of them were corrected by body surface area and acquired left atrial maximum volume index,minimum volume index,pre systolic volume index,the total left atrial ejection fraction,passive left atrial ejection fraction,and active left atrial ejection fraction were calculated.The differences between the two groups were compared.Results The left atrial maximum volume index,left atrial pre systolic volume index,left atrial minimum volume of the diabetes mellitus group were significantly higher and total left atrial ejection fraction,passive left atrial ejection fraction were lower than those of control group(P<0.05).There was no significant difference in active left atrial ejection fraction between diabetes mellitus group and control group(P>0.05).The GLS4C,GLS2C,GLS3C of the diabetes mellitus group were significantly lower than control group(P<0.05).Conclusion RT-3DE can be used to evaluate the left atrial volume and function changes and left ventricular systolic function can b

关 键 词：2型糖尿病 超声 斑点追踪 纵向应变 三维 

分 类 号：R540.4[医药卫生—心血管疾病] R587[医药卫生—内科学]