超声心肌做功技术对2型糖尿病患者潜在左心室心肌收缩功能损伤的评价  

Evaluation of potential left ventricular systolic dysfunction in patients with type 2 diabetes mellitus using ultrasonic myocardial work technology

作　　者：何金梅 尹立雪 谭静[1] 张文军[1] 王锐 任梅 廖明娇 He Jinmei;Yin Lixue;Tan Jing;Zhang Wenjun;Wang Rui;Ren Mei;Liao Mingjiao(Department of Ultrasound,Wenjiang Hospital Affiliated to Sichuan Provincial People’s Hospital,Chengdu 610000,China;Department of Cardiovascular Ultrasound and Cardiac Function,Sichuan People’s Hospital&Sichuan Academy of Medical Sciences,Chengdu 610000,China;Zunyi Medical University,Zunyi 563000,China;North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]四川省人民医院温江医院超声医学科,成都610000 [2]四川省医学科学院四川省人民医院心血管超声及心功能科,成都610000 [3]遵义医科大学,563000 [4]川北医学院,南充637000

出　　处：《中华医学超声杂志（电子版）》2023年第10期1029-1035,共7页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：四川省科技厅项目(2020YFH0183);中央高校基本科研业务费专项资金(ZYGX2020ZB038)。

摘　　要：目的应用心肌做功技术评价合并与不合并肥胖的2型糖尿病(T2DM)患者潜在左心室心肌收缩功能及同步性的异常改变,探讨心肌做功参数评估T2DM患者左心室收缩功能的临床应用价值。方法选取2020年12月至2021年8月四川省人民医院内分泌门诊就诊的T2DM患者共70例,根据体质量指数(BMI)分为2组:T2DM不合并肥胖组(BMI<25 kg/m^(2))32例,T2DM合并肥胖组(BMI≥25 kg/m^(2))38例。选取同期年龄、性别相匹配的健康体检者42例为对照组。3组均进行常规超声心动图检查获得左心室构型及功能参数,同时应用斑点追踪及心肌做功技术获得左心室整体纵向应变(GLS)、纵向应变达峰时间离散度(PSD)、整体有效功(GCW)、整体无效功(GWW)、整体做功指数(GWI)以及整体做功效率(GWE)。比较3组间参数的差异。结果对照组、T2DM不合并肥胖组、T2DM合并肥胖组左心室射血分数(LVEF)依次降低,差异无统计学意义(P>0.05)。与正常对照组相比,合并肥胖的T2DM组和不合并肥胖的T2DM组的GLS、GCW、GWI、GWE降低,GWW增高,与不合并肥胖的T2DM组相比,合并肥胖的T2DM组GCW、GWE降低,差异有统计学意义(P<0.05)。与正常对照组相比,合并肥胖组的T2DM组PSD增高,差异有统计学意义(P<0.05)。结论LVEF正常的T2DM患者的左心室收缩功能已经受损,肥胖加重T2DM患者左心室收缩功能受损程度。心肌做功参数可更敏感地评估潜在左心室收缩功能损伤。心肌做功技术可能成为临床评价射血分数正常的T2DM患者左心室收缩功能的无创新方法。Objective To evaluate the abnormal changes of potential left ventricular myocardial systolic function and synchronization in patients with type 2 diabetes mellitus(T2DM)with and without obesity by applying myocardial work technique,and to investigate the clinical application of myocardial work parameters in assessing left ventricular systolic function in patients with T2DM.Methods A total of 70 patients with T2DM attending the endocrine outpatient clinic of Sichuan Provincial People's Hospital from December 2020 to August 2021 were selected and divided into two groups according to body mass index(BMI):32 cases with T2DM not combined with obesity(BMI<25 kg/m^(2))and 38 cases with T2DM combined with obesity(BMI≥25 kg/m^(2)).Forty-two age-and gender-matched healthy physical examiners were selected as a control group during the same period.All the three groups underwent conventional echocardiography to obtain left ventricular configuration and function parameters,and at the same time,speckle tracking and myocardial work techniques were used to obtain the global longitudinal strain(GLS),peak strain dispersion(PSD),global constructive work(GCW),global wasted work(GWW),global work index(GWI),and global work efficiency(GWE).The differences in the above parameters were compared among the three groups of parameters.Results The left ventricular ejection fraction(LVEF)decreased sequentially in the normal control group,the T2DM without obesity group,and the T2DM with obesity group,but the differences were not statistically significant(P>0.05).Compared with the normal control group,GLS,GCW,GWI,and GWE were decreased and GWW was increased in the other two groups.Compared with T2DM patients without obesity,GCW and GWE in T2DM patients with obesity were decreased significantly(P<0.05).Compared with the normal control group,PSD was significantly increased in T2DM patients with obesity(P<0.05).Conclusion Left ventricular myocardial systolic function may have already been impaired in T2DM patients with normal LVEF,and obesity may

关 键 词：心肌做功 超声心动图 2型糖尿病 肥胖 左心室功能 

分 类 号：R587.1[医药卫生—内分泌] R54[医药卫生—内科学]