摘要
目的:应用分层应变评价2型糖尿病不同糖化血红蛋白(HbA1c)水平患者左心室心肌收缩功能变化情况。方法:收集HbA1c<6.5%(A1组)、6.5%≤HbA1c<9%(A2组)、HbA1c≥9%(A3组)的2型糖尿病患者与健康志愿者(B组)各20例,采集二维超声心动图与二维斑点追踪(2D-STE)图像,测量舒张末期左室后壁厚度(LVPWTd)、舒张末期室间隔厚度(IVSTd)、舒张末期左室前后径(LVEDd)、收缩末期左房前后径(LAd)、左室射血分数(LVEF)等常规超声心动图指标和左室壁18个节段内、中、外层心肌的收缩期峰值纵向应变(LS)、收缩期峰值圆周应变(CS)及整体的分层和全层应变值等2D-STE指标。比较4组间各参数的差异。结果:4组LVPWTd、IVSTd、LVEDd、LAd、LVEF的差异均无统计学意义(P>0.05)。4组左室整体内、中、外层及整体全层心肌,基底段、中间段、心尖段的3层心肌LS、CS的差异均有统计学意义(P<0.05),且均以A3组减低最显著。结论:分层应变技术可定量评估2型糖尿病患者左室各层及整体心肌收缩功能,在常规超声心动图检查LVEF等未发生明显变化时,已存在左室收缩功能减低,血糖水平控制越好,即HbA1c水平越低时,左室收缩功能越接近正常,有利于临床改善预后及疗效评估。
Objective: To evaluate the systolic function of the left ventricular in patients with different levels of glycated hemoglobin(HbA1 c) in type 2 diabetes by layer-specific strain. Methods: Each group including 20 cases(HbA1 c<6.5%(Group A1), 6.5%≤HbA1 c<9%(Group A2), HbA1 c≥9%(Group A3)) with type 2 diabetes and 20 healthy volunteers(Group B) were checked by two-dimensional echocardiography and two-dimensional speckle tracking echocardiography(2 D-STE). Parameters of two-dimensional echocardiography including left ventricular posterior wall thickness at end-diastole(LVPWTd), interventricular septal thickness at end-diastole(IVSTd), left ventricular diameter at end-diastole(LVEDd), left atrium diameter(LAd), left ventricular ejection fraction(LVEF), and the parameters of 2 D-STE including the peak systolic longitudinal strain(LS) and the peak systolic circumferential strain(CS) of whole stratification and full-thickness were obtained from inner, medial and outer myocardial(subendocardial, mid-myocardial and epicardial) layers of 18 segments in the left ventricular walls. The parameters were calculated and compared among 4 groups. Results: There were no significant differences in LVPWTd, IVSTd, LVEDd, LAd and LVEF among the 4 groups(P>0.05). The statistical significance was detected on the LS and CS among the whole inner,medial and outer myocardial layers and full-thickness in the 4 groups(P<0.05), and the most significant reduction in group A3. Statistical significance was revealed on the LS and CS of inner, medial and outer myocardial layers of basal, middle and apical segments in the 4 groups(P<0.05), and the most significant reduction in group A3. Conclusion: Layer-specific strain technique can quantitatively evaluate the changes of systolic function on all myocardial layers and full-thickness of left ventricles in patients with type 2 diabetes. The left ventricular systolic function was decreased when the conventional echocardiography showed no significant changes in LVEF. The better the blood glucose level
作者
刘越佳
任卫东
谭雪莹
LIU Yue-jia;REN Wei-dong;TAN Xue-ying(Department of Ultrasound,Shengjing Hospital of China Medical University,Shenyang 110004,China)
出处
《中国临床医学影像杂志》
CAS
CSCD
2021年第6期418-422,444,共6页
Journal of China Clinic Medical Imaging
基金
国家自然科学基金资助项目(编号81571686)。
关键词
心室功能
左
糖尿病
2型
超声心动描记术
多普勒
彩色
Ventricular Function
Left
Diabetes Mellitus
Type 2
Echocardiography
Doppler
Color
