二维斑点追踪技术评价糖尿病前期患者左心房功能改变的价值  

Value of two-dimensional speckle tracking imaging in evaluating the changes of left atrial function in patients with prediabetes

作　　者：王敏[1,2] 姚玉娟 汪瑶 张平洋 WANG Min;YAO Yujuan;WANG Yao;ZHANG Pingyang(Department of Cardiovascular Ultrasound,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China;Department of Ultrasound,Nanjing Pukou People’s Hospital,Nanjing 211800,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)心血管超声科,江苏南京210006 [2]江苏省南京市浦口人民医院超声科,江苏南京211800

出　　处：《医学影像学杂志》2024年第11期43-47,共5页Journal of Medical Imaging

基　　金：江苏省卫生健康委员会重点医学科研项目(编号:ZD2021048)。

摘　　要：目的探讨利用二维斑点追踪成像技术(2D-STI)评价糖尿病前期患者左心房心肌应变(率)的改变及其临床价值。方法选取糖尿病前期组患者33例,2型糖尿病组患者33例,匹配健康成年志愿者35例(对照组)为观察对象,记录一般实验室指标及常规超声检查左心参数,并利用2D-STI技术测量各组的左心房收缩期峰值应变(SS),左心房收缩期峰值应变率(s-SR),舒张早期峰值应变率(e-SR),舒张晚期峰值应变率(a-SR),对三组患者间测值进行统计学比较分析。结果1)与对照组比较,糖尿病前期组SS、s-SR、e-SR测值降低,a-SR增高,差异均有统计学意义[(35.14±2.39)%vs(30.71±3.06)%,(3.47±0.49)s^(-1) vs(3.02±0.45)s^(-1),(3.94±0.56)s^(-1) vs(3.22±0.61)s^(-1),(3.22±0.50)s^(-1) vs(3.58±0.48)s^(-1),P<0.05];2)与对照组相比,糖尿病组二尖瓣口舒张早期峰值流速(E)降低、晚期峰值流速(A)增加,E/A值减低,SS、s-SR、e-SR均明显降低,a-SR增高,差异有统计学意义[(88.63±6.84)cm/s vs(84.88±6.85)cm/s,(62.19±5.26)cm/s vs(64.90±2.54)cm/s,1.44±0.18 vs 1.31±0.13,(35.14±2.39)%vs(26.45±2.69)%,(3.47±0.49)s^(-1) vs(2.65±0.36)s^(-1),(3.94±0.56)s^(-1) vs(2.42±0.58)s^(-1),(3.22±0.50)s^(-1) vs(3.61±0.73)s^(-1),P<0.05];3)与糖尿病前期组比较,糖尿病组SS、s-SR、e-SR减低更明显[(30.71±3.06)%vs(26.45±2.69)%,(3.02±0.45)s^(-1) vs(2.65±0.36)s^(-1),(3.22±0.61)s^(-1) vs(2.42±0.58)s^(-1),P<0.05],a-SR两者无明显差异。以上数据表明临床上糖尿病前期患者左心房心肌储备和管道功能都已经开始减低,且随糖尿病病情进展而加剧;泵功能早期已代偿性增加。结论糖尿病前期患者的左心房心肌功能改变有其特性,二维斑点追踪可以敏锐地发现并评价其变化。Objective To evaluate the changes of left atrial longitudinal strain and strain rate in patients with prediabetes by two-dimensional speckle tracking imaging(2D-STI),and to explore its clinical application value.Methods 33 patients with prediabetes,33 patients with type 2 diabetes,and 35 healthy controls were selected as the study subjects.General laboratory indicators and conventional ultrasound left heart parameters were recorded.Left atrial peak strain(SS)and systolic strain rate(s-SR),left atrial peak early diastolic strain rate(e-SR),and late diastolic strain rate(a-SR)were measured by 2D-STI.The parameters of the three groups were statistically compared and analyzed.Results 1)Compared with the healthy control group,SS,s-SR and e-SR were decreased in the prediabetic group,while,a-SR was increased,and the differences were statistically significant[(35.14±2.39)%vs(30.71±3.06)%,(3.47±0.49)s^(-1) vs(3.02±0.45)s^(-1),(3.94±0.56)s^(-1) vs(3.22±0.61)s^(-1),(3.22±0.50)s^(-1) vs(3.58±0.48)s^(-1),P<0.05];2)Compared with the healthy control group,the E value decreased,the A value increased,the E/A value decreased,SS,s-SR and e-SR decreased significantly,and a-SR increased.These differences were statistically significant[(88.63±6.84)cm/s vs(84.88±6.85)cm/s,(62.19±5.26)cm/s vs(64.90±2.54)cm/s,1.44±0.18 vs 1.31±0.13,(35.14±2.39)%vs(26.45±2.69)%,(3.47±0.49)s^(-1) vs(2.65±0.36)s^(-1),(3.94±0.56)s^(-1) vs(2.42±0.58)s^(-1),(3.22±0.50)s^(-1) vs(3.61±0.73)s^(-1),P<0.05];and 3)Compared with the pre-diabetic group,the decrease of SS,s-SR and e-SR was more obvious in the diabetic group[(30.71±3.06)%vs(26.45±2.69)%,(3.02±0.45)s^(-1) vs(2.65±0.36)s^(-1),(3.22±0.61)s^(-1) vs(2.42±0.58)s^(-1),P<0.05],but there was no significant difference in a-SR.The results indicated that the left atrial myocardial reserve and duct function of pre-diabetic patients had begun to decrease,and became worse with the progression of diabetes.The left atrial pump function had increased compensatory in the early stage.Conclusion

关 键 词：糖尿病前期 超声检查 斑点追踪 左心房功能 应变率 

分 类 号：R587.1[医药卫生—内分泌] R445.2[医药卫生—内科学]