2型糖尿病老年病人心肌纤维化T1-Mapping与左心室应变参数的相关性分析  

Correlation between T1-mapping of myocardial fibrosis and left ventricular strain parameters in elderly patients with type 2 diabetes mellitus

作　　者：王玲[1] 鲁国卫[1] 章宏[1] 尹成俊[1] 陈凤 田荣华[1] WANG Ling;LU Guowei;ZHANG Hong;YIN Chengjun;CHEN Feng;TIAN Ronghua(Department of Radiology,Xiaogan Central Hospital,Xiaogan Hospital Affiliated to Wuhan University of Science and Technology,Xiaogan,Hubei 432000,China)

机构地区：[1]孝感市中心医院、武汉科技大学附属孝感医院放射科,湖北孝感432000

出　　处：《安徽医药》2024年第9期1866-1870,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探究2型糖尿病(T2DM)老年病人心肌纤维化T1-Mapping参数与左心室应变参数之间的相关性。方法以2019年8月至2022年8月在孝感市中心医院就诊的T2DM病人82例为研究对象,根据病人的病程分为短期T2DM组40例(病程<5年)和长期T2DM组42例(病程≥5年),以同期招募的健康志愿者40例为对照组。比较各组间左心室应变参数及T1-Mapping参数。采用多元线性逐步回归法分析T1-Mapping参数的影响因素。采用相关性分析T1-Mapping参数与左心室应变参数的相关性。结果短期T2DM组病人左室周向峰值舒张应变率(PDSR)[1.25(0.95,1.50)1/s比1.40(1.20,1.70)1/s]较对照组降低(P<0.05),细胞外体积(ECV)[31.00(29.00,33.50)%比29.00(27.00,32.00)%]较对照组升高(P<0.05)。与对照组比较,长期T2DM组病人左室纵向峰值应变(PS)[−14.50(−12.38,−16.50)%比−16.15(−14.60,−18.30)%]、径向PDSR[(−2.58±0.83)1/s比(−3.32±0.88)1/s]、周向PDSR[0.90(0.70,1.20)1/s比1.40(1.20,1.70)1/s]、纵向PDSR[0.70(0.58,0.90)1/s比1.10(0.80,1.38)1/s]降低(P<0.05),ECV[34.00(32.00,35.00)%比29.00(27.00,32.00)%]升高(P<0.05)。与短期T2DM组比较,长期T2DM组病人左室纵向PS[−14.50(−12.38,−16.50)%比−16.15(−14.45,−18.38)%]、径向PDSR[(−2.58±0.83)1/s比(−3.61±0.76)1/s]、周向PDSR[0.90(0.70,1.20)1/s比1.25(0.95,1.50)1/s]、纵向PDSR[0.70(0.58,0.90)1/s比1.10(0.80,1.30)1/s]降低(P<0.05),ECV[34.00(32.00,35.00)%比31.00(29.00,33.50)%]升高(P<0.05)。多元线性回归分析结果示,糖尿病病程是T2DM病人ECV的独立影响因素(β=0.29,P<0.05)。Spearman相关性分析结果示,T2DM病人ECV与左室纵向PS(r_(s)=0.35,P<0.05)、纵向峰值收缩应变率(PSSR)(r_(s)=0.31,P<0.05)呈显著正相关,与左室周向PDSR(r_(s)=−0.29,P<0.05)、纵向PDSR(r_(s)=−0.43,P<0.05)呈显著负相关。结论心脏磁共振T1-Mapping可能发现T2DM病人早期心肌纤维化,T1-Mapping参数与左心室应变参数显著相关。Objective To explore the correlation between T1-mapping parameter_(s)and left ventricular strain parameter_(s)of myocardial fibrosis in elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 82 T2DM patients who were treated at Xiaogan Central Hospital from August 2019 to August 2022 were selected as the research subjects.According to the disease duration of the pa-tients,they were divided into 40 patients in the short-term T2DM group(disease duration<5 year_(s))and 42 patients in the long-term T2DM group(disease duration≥5 year_(s)),and 40 healthy volunteer_(s)recruited during the same period composed the control group.The left ventricular strain parameter_(s)and T1-mapping parameter_(s)were compared between the groups.A multivariate linear stepwise regres-sion method was used to analyze the influencing factor_(s)of the T1-mapping parameter_(s).The correlation between T1-mapping parameter_(s)and left ventricular strain parameter_(s)was analyzed using correlation analysis.Results Compared with patients in the control group,pa-tients in the short-term T2DM group had a lower left ventricular circumferential peak diastolic strain rate(PDSR)[1.25(0.95,1.50)1/s vs.1.40(1.20,1.70)1/s](P<0.05),and greater extracellular volume(ECV)[31.00(29.00,33.50)%vs.29.00(27.00,32.00)%](P<0.05).Compared with those in the control group,patients in the long-term T2DM group had greater left ventricular longitudinal peak strain(PS)[-14.50(-12.38,-16.50)%vs.-16.15(-14.60.-18.30)%],radial PDSR[(-2.58±0.83)1/s vs.(-3.32±0.88)1/s],circumfer-ential PDSR[0.90(0.70,1.20)1/s vs.1.40(1.20,1.70)1/s],and longitudinal PDSR[0.70(0.58,0.90)1/s vs.1.10(0.80,1.38)1/s]were lower(P<0.05),and ECV[34.00(32.00,35.00)%vs.29.00(27.00,32.00)%]was greater(P<0.05).Compared with those in the short-term T2DM group,patients in the long-term T2DM group had greater left ventricular longitudinal PS[-14.50(-12.38,-16.50)%vs.-16.15(-14.45.-18.38)%],radial PDSR[(-2.58±0.83)1/s vs.(-3.61±0.76)1/s],circumferential PDSR[0.90(0.70,1.20)1/s vs.1.25(0.95,

关 键 词：糖尿病 2型 心脏磁共振 心肌纤维化 心肌应变 T1-Mapping参数 

分 类 号：R587.1[医药卫生—内分泌] R542.23[医药卫生—内科学]