摘要
目的采用四维超声自动左房定量(4D Auto LAQ)技术探讨早期糖尿病肾病患者左心房容积和功能改变。方法选取2020年3月至2021年4月于河南省人民医院就诊的早期糖尿病肾病患者40例(早期糖尿病肾病组)、2型糖尿病患者40例(糖尿病组),收集同期健康志愿者36例(对照组),测量常规超声心动图参数,四维容积探头完整留取5个心动周期左心房容积图像,采用EchoPAC工作站4D Auto LAQ软件分析,获取左心房容积和应变指标:左心房(LA)的最大容积(LAVmax)、最小容积(LAVmin)、收缩前容积(LAVpreA)、左心房最大容积指数(LAVImax)、左心房排空容积(LAEV)、左心房排空分数(LAEF)、左心房储存期、管道期及收缩期纵向及圆周应变(LASr、LASr-c;LAScd、LAScd-c;LASct、LASct-c),分析三组间以上参数的差异。结果三组间室间隔厚度(IVSd)、左室后壁厚度(LVPWd)、左室舒张期内径(LVIDd)、左室射血分数(LVEF)、二尖瓣口舒张早期血流峰值流速与舒张晚期血流峰值流速比值(E/A)差异无统计学意义(均P>0.05),三组间左心房前后径(LAD)、相对室壁厚度(RWT)、二尖瓣口舒张早期血流峰值流速与二尖瓣环水平左室侧壁舒张早期运动速度比值(E/e′)比较差异有统计学意义(均P<0.05),进一步两两比较结果显示LAD仅在早期糖尿病肾病组与对照组之间差异有统计学意义(P=0.012),RWT、E/e′在三组之间的差异有统计学意义(均P<0.05)。三组间LAEV、LAScd-c、LASct-c差异无统计学意义(均P>0.05),LAVmin、LAVmax、LAVpreA、LAVImax、LAEF、LASr、LAScd、LASct、LASr-c差异有统计学意义(均P<0.05),两两比较结果显示早期糖尿病肾病组与对照组及糖尿病组相比LAVmin、AVpreA、LAVImax增加(均P<0.05),LAEF、LAScd、LASct、LASr-c减低(均P<0.05);糖尿病组LAVmax、LAVImax、LASct较对照组增加(均P<0.05),LAEF、LAScd、LASr-c较对照组减低(均P<0.05)。结论4D Auto LAQ技术可定量评价早期糖尿病肾病左心�
Objective To explore the changes of left atrial volume and function in patients with early diabetic nephropathy by four-dimensional auto left atrial quantification(4D Auto LAQ).Methods Forty patients with early diabetic nephropathy(early diabetic nephropathy group),40 patients with type 2 diabetes(diabetes group)in Henan Provincial People′s Hospital from March 2020 to April 2021 were selected,and 36 healthy volunteers(control group)were collected during the same period.The parameters of conventional echocardiography were measured,and the four-dimensional volume probe was used to obtain the complete left atrial volume image in 5 cardiac cycles.The 4D Auto LAQ software on the EchoPAC workstation was used for analysis to obtain the left atrial volume and strain indicators:left atrial(LA)maximum volume(LAVmax),left atrial minimum volume(LAVmin),pre-systolic volume(LAVpreA),left atrial volume index(LAVImax),left atrial emptying volume(LAEV),left atrial emptying fraction(LAEF),and long axis and circumferential strains in left atrial reserve phase,pipeline phase and systolic phase(LASr,LASr-c;LAScd,LAScd-c;LASct,LASct-c).The differences of these parameters among 3 groups were analyzed.Results There were no significant differences in interventricular septum end-diastolic thickness(IVSd),left ventricular posterior wall end-diastolic thickness(LVPWd),left ventricular end-diastolic dimension(LVIDd),left ventricular ejection fraction(LVEF),and E/A(ration of early to late diastolic peak flow velocity of mitral orifice)among 3 groups(all P>0.05),and left atrial diameter(LAD),relative wall thickness(RWT),and E/e′(ration of early diastolic peak flow velocity of mitral orifice to early diastolic velocity of lateral mitral annulus)among 3 groups were significantly different(all P<0.05).Further pairwise comparison results showed that LAD was only significantly different between the early diabetic nephropathy group and control group(P=0.0012),and the differences in RWT and E/e′were statistically significant among 3 groups(all
作者
王一洒
朱好辉
张喜君
朱丽敏
魏常华
陈纪昀
申凯凯
田婧
袁建军
Wang Yisa;Zhu Haohui;Zhang Xijun;Zhu Limin;Wei Changhua;Chen Jiyun;Shen Kaikai;Tian Jing;Yuan Jianjun(Department of Ultrasound,Henan People′s Hospital,Zhengzhou 450003,China;Department of Ultrasound,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450099,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2022年第5期407-413,共7页
Chinese Journal of Ultrasonography
基金
河南省科技厅2021年度科技攻关计划(212102310652)
河南省教育厅高等学校重点科研项目计划(19B320010)。
关键词
四维超声自动左房定量技术
糖尿病
早期糖尿病肾病
左房容积
心房功能
左
Four-dimensional auto left ventricular quantification
Diabetes
Diabetic nephropathy
Left atrial volume
Atrial function,left
