超声心动图评估射血分数保留的2型糖尿病患者心室-动脉耦联的临床价值  

Clinical value of echocardiography in the evaluation of ventricular-arterial coupling in type 2 diabetes mellitus patients with preserved ejection fraction

作　　者：左晓文 陈美杉 闫玲[1] 张灿 袁曼莉 周凤侠 贾化平 ZUO Xiaowen;CHEN Meishan;YAN Ling;ZHANG Can;YUAN Manli;ZHOU Fengxia;JIA Huaping(Department of Ultrasound Diagnosis,the Ninth Medical Center of PLA General Hospital,Beijing 100100,China;Department of Ultrasound Diagnosis,Xingcheng Special Duty Sanatorium of People’s Liberation Army Joint Logistic Support Force,Huludao 125105,China)

机构地区：[1]解放军总医院第九医学中心超声诊断科,北京100100 [2]中国人民解放军联勤保障部队兴城特勤疗养中心超声诊断科,辽宁葫芦岛125105

出　　处：《临床超声医学杂志》2025年第3期183-187,共5页Journal of Clinical Ultrasound in Medicine

基　　金：解放军总医院第九医学中心博士毕业生科研启动基金项目(21ZX17)。

摘　　要：目的应用超声心动图评估射血分数保留的2型糖尿病(T2DM)患者心室-动脉耦联,探讨其临床应用价值。方法选取79例射血分数保留的T2DM患者(T2DM组)和58例健康成人(对照组),获取其常规超声心动图参数、左室整体应变参数及心室-动脉耦联参数,比较两组上述参数的差异。采用Pearson相关分析法分析VAC与左室功能参数的相关性。结果T2DM组左房前后径、室间隔厚度、左室后壁厚度、二尖瓣口舒张晚期峰值流速(A)、二尖瓣口舒张早期峰值流速(E)与二尖瓣环舒张早期运动速度(e’)比值、有效动脉弹性及心室-动脉耦联指数(VAC)均高于对照组,e’、整体纵向应变(GLS)、整体圆周应变(GCS)、整体面积应变(GAS)均低于对照组,差异均有统计学意义(均P<0.05);两组左室收缩末弹性比较差异无统计学意义。相关性分析显示,VAC与GLS、GCS、GAS及E/e’均相关(r=0.57、-0.68、0.79、-0.57,均P<0.05),与A、e’无相关性(r=-0.23、-0.35,均P>0.05)。结论VAC与早期心肌功能异常相关,超声心动图能够定量、无创地评估射血分数保留的T2DM患者心室-动脉耦联,具有较好的临床应用价值。Objective To evaluate ventricular-arterial coupling in type 2 diabetes mellitus(T2DM)patients with preserved ejection fraction by echocardiography,and to explore its clinical application value.Methods Seventy-nine T2DM patients with preserved ejection fraction(T2DM group)and 58 healthy adults(control group)were enrolled.Conventional echocardiographic parameters,left ventricular global strain parameters,ventricular-arterial coupling parameters were obtained,and the differences of these parameters between the two groups were compared.Pearson correlation analysis was used to analyze the relationship between VAC and left ventricular functional parameters.Results The T2DM group showed significantly higher values in left atrial anteroposterior diameter,interventricular septum thickness,left ventricular posterior wall thickness,late diastolic peak flow velocity(A),ratio of early mitral inflow velocity(E)to early diastolic mitral annular velocity(e’),effective arterial elastance,and ventricular-arterial coupling index(VAC)compared to the control group(all P<0.05).While e’,global longitudinal strain(GLS),global circumferential strain(GCS),and global area strain(GAS)in T2DM group were significantly lower than those in the control group(all P<0.05).No significant difference in end-systolic elastance between the two groups.Correlation analysis showed that VAC was significantly correlated with GLS,GCS,GAS,and E/e’(all P<0.05),and not correlated with A,e’(r=-0.23,-0.35,both P>0.05).Conclusion VAC is significantly associated with early myocardial dysfunction in T2DM patients with preserved ejection fraction.Echocardiography provides a noninvasive and quantitative method to evaluate the ventricular-arterial coupling in T2DM patients,demonstrating significant clinical application value.

关 键 词：超声心动描记术 斑点追踪技术 2型糖尿病 射血分数保留 心室-动脉耦联 

分 类 号：R540.45[医药卫生—心血管疾病]