实时三维超声心动图评估2型糖尿病患者左心室收缩同步性  

Evaluation of left ventricular systolic synchronization in patients with type 2 diabetes mellitus by real-time three-dimensional echocardiography

作　　者：马兰[1] 邵宏增 赵新鑫 刘泳 赵迎东 MA Lan;SHAO Hongzeng;ZHAO Xinxin;LIU Yong;ZHAO Yingdong(Department of Function,Qingdao Hiser Hospital Affiliated of Qingdao University(Qingdao Traditional Chinese Medicine Hospital),Qingdao 266033,China;Department of Ultrasonography,The Infectious Disease Hospital of Zibo,Zibo 255067,China;Department of Cardiovascular Ultrasound,Qingdao Central Hospital,University of Health and Rehabilitation Sciences(Qing-dao Central Medical Group),Qingdao 266033,China)

机构地区：[1]青岛大学附属青岛市海慈医院(青岛市中医医院)功能检查科,山东青岛266033 [2]山东省淄博市传染病医院超声科,山东淄博255067 [3]康复大学附属青岛中心医院(青岛市中心医疗集团)心血管超声科,山东青岛266033

出　　处：《医学影像学杂志》2024年第11期53-56,61,共5页Journal of Medical Imaging

基　　金：山东省中医药科技项目(编号:M-2022008)。

摘　　要：目的探讨应用实时三维超声心动图(RT-3DE)评估2型糖尿病(T2DM)患者左心室收缩运动同步性。方法选取60例T2DM患者作为观察组,分为未合并微血管病变(DM 1组)30例、合并微血管病变(DM 2组)30例,同时纳入30例健康志愿者为对照组。比较三组常规二维超声心动图参数和RT-3DE参数:左心室16节段达最小收缩容积时间的标准差和最大差值(Tmsv 16-SD、Tmsv 16-Dif),用R-R间期标化校正,记录Tmsv 16-SD/R-R、Tmsv 16-Dif/R-R,并分析DM 1组、DM 2组Tmsv 16-SD/R-R、Tmsv 16-Dif/R-R与3D-LVEF的相关性。结果DM 1组Tmsv 16-SD、Tmsv 16-Dif、Tmsv 16-SD/R-R、Tmsv 16-Dif/R-R均高于对照组,DM 2组3D-LVESV、3D-LVEF均低于对照组,3D-LVSV、Tmsv 16-SD、Tmsv 16-Dif、Tmsv 16-SD/R-R、Tmsv 16-Dif/R-R均高于对照组,差异均有统计学意义(P<0.05)。DM 2组3D-LVEF低于DM 1组,3D-LVSV、Tmsv 16-SD、Tmsv 16-Dif、Tmsv 16-SD/R-R、Tmsv 16-Dif/R-R均高于DM 1组,差异均有统计学意义(P<0.05)。DM 1组、DM 2组Tmsv 16-SD/R-R、Tmsv 16-Dif/R-R与3D-LVEF呈负相关(DM 1组r=-0.682、-0.631,DM 2组r=-0.717、-0.634,P<0.05)。结论T2DM造成左心室舒张、收缩功能受损,RT-3DE可早期检测左心室心肌收缩运动同步性,评估左心室功能受损程度。Objective To evaluate the left ventricular systolic synchronization in patients with type 2 diabetes mellitus(T2DM)by real-time three-dimensional echocardiography(RT-3DE).Methods A total of 60 patients with T2DM were divided into two groups:DM 1 group(without microangiopathy,30 cases)and DM 2 group(with microangiopathy,30 cases),other 30 healthy adults were included into control group.We compared their two-dimensional ultrasonic parameters and RT-3DE parameters,i.e.,the time to minimal systolic volume of 16-segmental standard deviation and maximum difference(Tmsv 16-SD,Tmsv 16-Dif).Cardiac cycle was standardized,Tmsv 16-SD/R-R and Tmsv 16-Dif/R-R were got,and the correlation between Tmsv 16-SD/R-R,Tmsv 16-Dif/R-R and 3D-LVEF was analyzed.Results Tmsv 16-SD,Tmsv 16-Dif,Tmsv 16-SD/R-R,Tmsv 16-Dif/R-R in DM 1 group were significantly increased than those of the control group(P<0.05),3D-LVESV,3D-LVEF were significantly decreased and 3D-LVSV,Tmsv 16-SD,Tmsv 16-Dif,Tmsv 16-SD/R-R,Tmsv 16-Dif/R-R in DM 2 group were significantly increased than those of the control group(P<0.05).3D-LVEF was significantly decreased and 3D-SV,Tmsv 16-SD,Tmsv 16-Dif,Tmsv 16-SD/R-R,Tmsv 16-Dif/R-R were significantly increased in DM 2 group than those of the DM 1 group(P<0.05).Tmsv 16-SD/R-R and Tmsv 16-Dif/R-R were negatively correlated with 3D-LVEF(r=-0.682,-0.631 in DM 1 group,r=-0.717,-0.634 in DM 2 group,P<0.05).Conclusion T2DM can impair left ventricular diastolic and systolic function.RT-3DE can detect left ventricular systolic synchronization in patients with T2DM and evaluate the degree of left ventricular dysfunction.

关 键 词：实时三维超声心动图 2型糖尿病 收缩同步性 左心室 

分 类 号：R542.2[医药卫生—心血管疾病] R445.1[医药卫生—内科学]