摘要
目的基于心肌斑点追踪技术及实时三维超声技术探讨2型糖尿病患者左心房容积、功能及心肌应变及其与血清炎性指标的相关性研究。方法收集2018年9月至2021年12月于我院就诊的2型糖尿病患者328例,其中单纯2型糖尿病患者220例,早期糖尿病肾病患者108例,选取同期于我院就诊134例健康体检者为对照组。应用二维心肌斑点追踪技术评估患者左心房应变,分别得到三腔心切面左房峰值纵向应变(PALS-LAX)、四腔心切面左房峰值纵向应变(PALS-A4C)、两腔心切面左房峰值纵向应变(PALS-A2C)、左房平均峰值纵向应变(LA-PALS)。应用三维超声评估左心房容积及收缩功能,得到左房最大容积指数(LAVImax)、左房收缩前容积指数(LAVIp)、左房最小容积指数(LAVImin)及左房总排空分数(LATEF);同时记录受试者炎性相关血清学指标。结果3组LAVImin及左心房应变指标:PALS-LAX、PALS-A2C、LA-PALS比较,差异均有统计学意义(P<0.05)。与对照组比较,单纯糖尿病组患者LAVImin增大,PALS-LAX、PALS-A2C、LA-PALS减小(P<0.05);与单纯糖尿病组比较,早期糖尿病肾病组患者LAD、EDT、E/e′、LAVImax、LAVImin增大,E/A和LATEF降低,左心房应变指标:PALS-LAX、PALS-A4C、PALS-A2C、LA-PALS进一步减小(P均<0.05)。相关性研究发现,餐后2 h血糖与LAVImin、LA-PALS、E/e′呈负相关(r=-0.583、-0.788,-0.414,P<0.05);糖化血红蛋白与LAVImin、E/e’呈负相关(r=-0.439、-0.551,P<0.05);IL-6及IL-8与LA-PALS呈负相关(r=-0.541、-0.429,P<0.05);IL-6及IL-8与LAVImin呈负相关(r=-0.572、-0.517,P<0.05);血清β2微球蛋白与LAVImin、LA-PALS呈负相关(r=-0.614、-0.568,P<0.05)。结论2型糖尿病患者随病程进展逐渐出现左心房心肌应变减低、左心房增大及排空功能减低;LA-PALS及LAVImin与患者餐后2 h血糖水平、血清β2微球蛋白IL-6、IL-8水平呈负相关。
Objective To explore left atrial volume,function and strain in type 2 diabetes and its correlation with serum inflammatory markers.Methods We collected 328 patients with type 2 diabetes mellitus who visited our hospital from September 2018 to December 2021,including 220 patients with simple type 2 diabetes mellitus and 108 patients with early diabetic nephropathy,and 134 health checkups who visited our hospital during the same period were selected as the control group.Two-dimensional myocardial speckle tracking technology was used to evaluate the left atrial strain of patients,and we obtained the three-chamber view of the peak left atrial longitudinal strain(PALS-LAX),the four-chamber view of the peak left atrial longitudinal strain(PALS-A4C),the two-chamber view of the peak atrial global longitudinal strain(PALS-A2C)and the peak left atrial global mean longitudinal strain(LA-PALS).The left atrial structure and systolic function were evaluated by three-dimensional ultrasound,and the left atrial maximum volume index(LAVImax),left atrial presystolic volume index(LAVIp),left atrial minimum volume index(LAVImin)and left atrial total emptying fraction(LATEF)were obtained;at the same time,the inflammation-related serological indicators of the subjects were recorded.Results There were statistically significant differences in LAVImin,PALS-LAX,PALS-A2C,and LA-PALS among the groups(P<0.05).Compared with the control group,LAVImin in the simple diabetes group increased,PALS-LAX,PALS-A2C,LA-PALS decreased(P<0.05),LAD,EDT,E/e′,LAVImax and LAVImin in the early diabetic nephropathy group increased,E/A and LATEF decreased,PALS-LAX,PALS-A4C,PALS-A2C and LA-PALS were lower than those in the control group(all P<0.05).Correlation studies found that:2-hour postprandial blood glucose was negatively correlated with LAVImin,LA-PALS and E/e′(r=-0.583,-0.788,-0.414,P<0.05);IL-6 and IL-8 were negatively correlated with LA-PALS(r=-0.541,-0.429,P<0.05);IL-6 and IL-8 were negatively correlated with LAVImin(r=-0.572,-0.517,P<0.05);Serumβ2-
作者
张忆雯
田刚
张洁
魏亚娟
相里伟
金鑫
Zhang Yiwen;Tian Gang;Zhang Jie(Department of Cardiovascular Surgery,Department of Ultrosound,the Second Affiliated Hospital of Xi’an Jiaotong University,Xi an,Shanxi 710004;Department of Cardiology,the First Affiliated Hospital of Xi’an Jiaotong University,Xi an,Shanxi 710004,China)
出处
《四川医学》
CAS
2024年第2期123-128,共6页
Sichuan Medical Journal
基金
国家自然科学基金项目资助(编号:81873513)。
