左室压力-应变环评估肥胖2型糖尿病患者左室收缩功能的临床价值  

Clinical value of left ventricular pressure-strain loop in evaluating left ventricular systolic function in obese patients with type 2 diabetes mellitus

作　　者：刘姝妮 张维[2] 陈凤[1] LIU Shuni;ZHANG Wei;CHEN Feng(Department of Ultrasound,Chongqing University Central Hospital,Chongqing Emergency Medical Center,Chongqing 400014,China)

机构地区：[1]重庆大学附属中心医院重庆市急救医疗中心超声科,重庆市400014 [2]重庆市中医院超声科

出　　处：《临床超声医学杂志》2024年第9期768-772,共5页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨左室压力-应变环评估肥胖2型糖尿病(T2DM)患者左室收缩功能的临床应用价值。方法选取我院收治的T2DM患者84例,根据体质量指数(BMI)分为T2DM伴肥胖组41例(BMI≥25 kg/m^(2))和T2DM不伴肥胖组43例(BMI<25 kg/m^(2)),均行常规超声心动图和左室压力-应变环检查并获取相关参数,比较两组各参数的差异。采用多因素Logistic回归分析筛选肥胖T2DM患者左室收缩功能受损的独立影响因素;分析肥胖T2DM患者GLS和心肌做功参数与BMI的相关性。结果两组常规超声心动图参数比较差异均无统计学意义。T2DM伴肥胖组整体纵向应变(GLS)、整体有效功(GCW)、整体做功效率(GWE)均低于T2DM不伴肥胖组,整体无效做功(GWW)、整体做功指数(GWI)均高于T2DM不伴肥胖组,差异均有统计学意义(均P<0.05)。多因素Logistic回归分析显示,BMI、GWW、GWI均为肥胖T2DM患者左室收缩功能受损的独立危险因素(OR=1.973、1.619、1.748,均P<0.05),GLS、GCW、GWE均为独立保护因素(OR=0.847、0.814、0.781,均P<0.05)。肥胖T2DM患者GWI、GWW与BMI均呈正相关(r=0.673、0.633,均P<0.001),GLS、GCW、GWE与BMI均呈负相关(r=-0.611、-0.597、-0.681,均P<0.001)。结论肥胖可能会加重T2DM患者左室重构和收缩功能受损,左室压力-应变环在评估肥胖T2DM患者左室收缩功能中具有一定的临床应用价值。Objective To explore the clinical application value of left ventricular pressure-strain loop in evaluating left ventricular systolic function in obese patients with type 2 diabetes mellitus(T2DM).Methods A total of 84 patients with T2DM from our hospital were selected and divided into T2DM with obesity group[n=41,body mass index(BMI)≥25 kg/m^(2)]and T2DM without obesity group(n=43,BMI<25 kg/m^(2))according to the BMI.Conventional echocardiography and left ventricular pressure-strain loop examination were performed to obtain relevant parameters,and the differences of various parameters between the two groups were compared.Multivariate Logistic regression analysis was used to screen the independent influencing factors of left ventricular systolic dysfunction in obese patients with T2DM.The correlation between global longitudinal strain(GLS),myocardial work parameters and BMI in obese patients with T2DM were analyzed.Results There were no significant difference in conventional echocardiographic parameters between the two groups.The GLS,global constructive work(GCW)and global work efficiency(GWE)in T2DM with obesity group were lower than those in T2DM without obesity group,while global wasted work(GWW)and global work index(GWI)were higher(all P<0.05).Multivariate Logistic regression analysis showed that BMI,GWW and GWI were independent risk factors for left ventricular systolic dysfunction in obese patients with T2DM(OR=1.973,1.619,1.748,all P<0.05),while GLS,GCW,and GWE were independent protective factors(r=0.847,0.814,0.781,all P<0.05).In obese patients with T2DM,GWI and GWW were positively correlated with BMI(r=0.673,0.633,both P<0.001),while GLS,GCW and GWE were negatively correlated with BMI(r=-0.611,-0.597,-0.681,all P<0.05).Conclusion Obesity may aggravate left ventricular remodeling and dysfunction in patients with T2DM.The left ventricular pressure-strain loop has certain clinical application value in evaluating left ventricular systolic function in obese patients with T2DM.

关 键 词：超声心动描记术 压力-应变环 2型糖尿病 肥胖 收缩功能 左室 

分 类 号：R540.45[医药卫生—心血管疾病] R587.1[医药卫生—内科学]