摘要
目的探讨分层应变技术在2型糖尿病(type 2 diabetes mellitus, T2DM)并冠状动脉微循环障碍(coronary microvascular dysfunction, CMD)患者左心室收缩功能评估中的应用价值。方法 45例T2DM患者,均行核素心肌灌注显像检查,提示存在CMD者24例为糖尿病A组,无CMD者21例为糖尿病B组;同期30例体检健康者为对照组。3组行超声心动图检查测量左心室舒张末期内径(left ventricular end-diastolic dimension, LVEDd)、左心室收缩末期内径(left ventricular end-systolic dimension, LVEDs)、左室射血分数(left ventricular ejection fraction, LVEF)、室间隔厚度(interventricular septal thickness, IVST)、左心室后壁厚度(left ventricular posterior wall thickness, LVPW);采集左心室心尖两腔、三腔及四腔的二维灰阶动态图像,分析后得到左心室心肌整体内层纵向应变(global longitudinal strain of the endocardium, GLSendo)、整体中层纵向应变(global longitudinal strain of the mid-myocardium, GLSmid)、整体外层纵向应变(global longitudinal strain of the epicardium, GLSepi)及峰值应变离散度(peak strain dispersion, PSD),并进行比较。结果糖尿病A组、糖尿病B组、对照组LVEDd[(43.92±3.51)、(43.11±3.84)、(43.86±3.94)mm]、LVEDs [(28.46±2.24)、(28.29±2.02)、(28.33±2.50)mm]、LVEF [(64.71±3.28)%、(65.82±3.89)%、(65.87±3.39)%]、IVST [(10.04±0.56)、(10.23±0.61)、(10.01±0.55)mm]、LVPW[(9.69±0.49)、(9.87±0.42)、(9.73±0.46)mm]比较差异均无统计学意义(P>0.05);糖尿病A组、糖尿病B组、对照组左心室心肌GLSendo[(23.26±1.42)%、(25.76±1.48)%、(27.20±1.99)%]、GLSmid[(20.02±0.98)%、(22.30±1.29)%、(23.61±1.48)%]、GLSepi[(17.56±0.95)%、(19.96±1.11)%、(20.98±1.11)%]依次增高(P<0.05),PSD[(37.87±7.47)、(31.29±5.99)、(23.24±4.16)ms]依次减低(P<0.05)。结论分层应变技术可检测T2DM并CMD患者左心室收缩功能改变。
Objective To investigate the clinical value of layer-specific strain to the assessment of left ventricular systolic function in patients with type 2 diabetes mellitus(T2 DM) complicated with coronary microvascular dysfunction(CMD). Methods Forty-five patients with T2 DM underwent myocardial perfusion imaging and were divided into 24 patients with CMD(CMD group) and 21 patients without CMD(non-CMD group), while another 30 healthy volunteers were as controls(control group). Echocardiography was performed to measure left ventricular end-diastolic dimension(LVEDd), left ventricular end-systolic dimension(LVEDs), left ventricular ejection fraction(LVEF), interventricular septal thickness(IVST) and left ventricular posterior wall thickness(LVPW) in three groups. Two-dimensional dynamic images of left ventricle, as well as two-, three-and four-chamber views were collected to analyze the global longitudinal strain of the endocardium(GLSendo),global longitudinal strain of the mid-myocardium(GLSmid),global longitudinal strain of the epicardium(GLSepi)and peak strain dispersion(PSD)in three groups.Results There were no significant differences in LVEDd((43.92±3.51),(43.11±3.84),(43.86±3.94)mm),LVEDs((28.46±2.24),(28.29±2.02),(28.33±2.50)mm),LVEF((64.71±3.28)%,(65.82±3.89)%,(65.87±3.39)%),IVST((10.04±0.56),(10.23±0.61),(10.01±0.55)mm),and LVPW((9.69±0.49),(9.87±0.42),(9.73±0.46)mm)among CMD group,non-CMD group and control group(P>0.05).GLSendo((23.26±1.42)%,(25.76±1.48)%,(27.20±1.99)%),GLSmid((20.02±0.98)%,(22.30±1.29)%,(23.61±1.48)%)and GLSepi((17.56±0.95)%,(19.96±1.11)%,(20.98±1.11)%)increased and PSD((37.87±7.47),(31.29±5.99),(23.24±4.16)ms)decreased gradually in turn in CMD group,non-CMD group and control group(P<0.05).Conclusion Layer-specific strain can sensitively evaluate the left ventricular systolic function in patients with T2 DM and CMD.
作者
颜宁
马玉磊
郑磊
张苗
孙璐冰
尹明慧
田新桥
YAN Ning;MA Yulei;ZHENG Lei;ZHANG Miao;SUN Lubing;YIN Minghui;TIAN Xinqiao(Department of Ultrasound,Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Central China Fuwai Hospital,Zhengzhou450003,China;Department of Nuclear Medicine,Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Central China Fuwai Hospital,Zhengzhou450003,China;Department of Endocrinology,Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Central China Fuwai Hospital,Zhengzhou450003,China)
出处
《中华实用诊断与治疗杂志》
2020年第3期293-296,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
国家自然科学基金(U1704175)。
关键词
2型糖尿病
冠状动脉微循环障碍
超声心动图描记术
分层应变
左心室功能
type 2 diabetes mellitus
coronary microvascular dysfunction
echocardiography
layer-specific strain
left ventricular function
