基于超声心动图分层应变及心肌做功技术的肥胖合并糖尿病患者左心室功能评价  

Utilizing layer-specific strain and myocardial work assessment techniques by echocardiography to evaluate left ventricular function in obese patients with diabetes mellitus

作　　者：周林燕 杨红宇 李萍[1] 康春松[2] Zhou Linyan;Yang Hongyu;Li Ping;Kang Chunsong(Department of Medical Imaging,Shanxi Medical University,Taiyuan 030001,China;Department of Ultrasound,the Third Affiliated Hospital of Shanxi Medical University/Shanxi Bethune Hospital,Taiyuan 030032,China)

机构地区：[1]山西医科大学医学影像学院,太原030001 [2]山西医科大学附属第三医院/山西白求恩医院超声科,太原030032

出　　处：《中华解剖与临床杂志》2024年第7期437-443,共7页Chinese Journal of Anatomy and Clinics

摘　　要：目的探讨基于超声心动图分层应变及心肌做功技术的肥胖合并糖尿病患者左心室功能的评估价值。方法回顾性队列研究。纳入2020年12月—2023年4月山西白求恩医院就诊的肥胖及糖尿病患者161例,其中男63例、女98例,年龄19~44(25.8±4.4)岁。将患者分为3组:57例单纯肥胖患者为肥胖组,53例单纯糖尿病患者为糖尿病组,51例肥胖合并糖尿病患者为肥胖合并糖尿病组。同期选取42名健康志愿者为对照组,其中男19名、女23名,年龄为19~36(25.4±4.4)岁。受试者均行常规超声心动图检查,将超声心动图导入EchoPAC 203工作站,应用分层应变技术,获取左心室心内膜层、心肌中层和心外膜层的整体纵向应变(GLSendo、GLSmid、GLSepi)及左心室纵向应变跨壁阶差(ΔGLS=GLSendo-GLSepi)。同时,利用心肌做功技术,得到了整体有用功(GCW)、整体做功指数(GWI)、整体做功效率(GWE)以及整体无用功(GWW)。观察并比较各组间基线资料、常规超声心动图参数、分层应变及心肌做功参数。结果(1)基线资料组间比较:患者性别、年龄、B型脑钠肽(BNP)、高敏肌钙蛋白-I、肌红蛋白、肌酸激酶同工酶4组间比较,差异均无统计学意义(P值均>0.05)。肥胖合并糖尿病组及肥胖组患者的BMI分别为(33.08±1.70)、(31.56±2.01)kg/m 2,均高于对照组及糖尿病组的(20.87±1.01)、(20.79±1.50)kg/m 2,差异有统计学意义(F=838.69,P<0.001);肥胖合并糖尿病组和糖尿病组空腹血糖分别为(8.92±1.39)、(8.88±1.33)mmol/L,糖化血红蛋白分别为7.80%±1.08%、7.84%±0.89%,均高于对照组及肥胖组的(5.22±1.03)mmol/L、(5.32±0.82)mmol/L、5.50%±1.01%、5.50%±0.60%,差异均有统计学意义(F=164.09、112.85,P值均<0.001)。(2)常规超声心动图参数组间比较:4组患者的舒张末期左室内径、收缩末期左室内径、左室射血分数比较,差异均无统计学意义(P值均>0.05)。肥胖组、糖尿病组及肥胖合并糖尿病组患�ObjectiveThis study aimed to evaluate left ventricular function in obese patients with diabetes mellitus through echocardiographic speckle tracking strain imaging and myocardial work technology.MethodsA retrospective cohort study was conducted on 161 patients with obesity and diabetes mellitus who were admitted to the Bethune Hospital of Shanxi Province from December 2020 to April 2023.Among them,63 were males and 98 females,aged 19-44(25.8±4.4)years.The patients were divided into three groups,namely,57 patients with pure obesity as the obesity group,53 patients with pure diabetes mellitus as the diabetes group,and 51 patients with obesity and diabetes mellitus as the obesity-diabetes group.The control group comprised 42 healthy volunteers during the same period,including 19 males and 23 females,aged 19-36(25.4±4.4)years.All subjects underwent conventional echocardiography,and the echocardiographic data were imported into the EchoPAC 203 workstation.The global longitudinal strain of the endocardium,myocardium,and epicardium(GLSendo,GLSmid,and GLSepi)and the transmural difference of longitudinal strain of the left ventricle(ΔGLS=GLSendo-GLSepi)was obtained using the layer-specific strain technique.Additionally,myocardial-work techniques were utilized to derive the global constructive work(GCW),global work index(GWI),global work efficiency(GWE),and global wasted work(GWW).The clinical baseline data,conventional echocardiographic parameters,stratified strain and myocardial-work parameters of each group were observed and compared.Results(1)No statistically significant differences in gender,age,BNP,high-sensitivity troponin I,and creatinine kinase isoenzyme was observed among the four groups(all P values>0.05).The BMIs of the obesity-diabetes group([33.08±1.70]kg/m 2)and the obesity group([31.56±2.01]kg/m 2)were higher than those of the control and diabetes groups([20.87±1.01]kg/m 2 and[20.79±1.50]kg/m 2),and the differences were statistically significant(F=838.69,P<0.001).Fasting blood glucose in the obesity a

关 键 词：糖尿病 肥胖症 超声心动描记术 心室动脉 左 分层应变技术 心肌做功技术 

分 类 号：R587.2[医药卫生—内分泌] R540.45[医药卫生—内科学]