斑点追踪显像技术对2型糖尿病患者左室收缩功能的研究

Role of ultrasound speckle tracking imaging in assessment of left ventricular systolic function of patients with type 2 diabetes mellitus

目的应用超声二维斑点追踪技术(STI)评价2型糖尿病患者左心室收缩功能。方法 2型糖尿病36例,左心室射血分数≥50%:正常对照41例。分别测量左心室长轴各水平纵向应变(GLs)和短轴各水平径向应变(GRs)和圆周应变(GCs),通过左室短轴二尖瓣和心尖水平计算扭转角度峰值(LVtw)。结果与对照组比较,糖尿病组左心室基底段、中间段、心尖段平均纵向峰值应变及左心室整体纵向应变显著减低(P<0.01),左心室短轴各水平平均径向应变减低,但差异无统计学意义(P>0.05);糖尿病组各水平圆周应变及左心室整体圆周应变减低(P<0.05),各水平旋转角度及左心室扭转角度增大(P<0.05);两组GLs、GRs、GCs及LVtw与LVEF显著相关,对照组GLs、GCs为LVEF的独立预测因子,回归方程为LVEF=29.81-1.5GLs-0.91GCs(P<0.01);糖尿病组GLs为LVEF的独立预测因子,回归方程为LVEF=31.83-2.72GLs(P<0.01)。结论超声斑点追踪成像技术能够评价2型糖尿病早期左心室局部和整体收缩功能异常。

Objective To assess the left ventricular systolic function of patients with type 2 diabetes mellitus with two-dimensional ultrasound speckle tracking technique（STI）.Methods Longitudinal strain（GLs） of the long axis,radial strain（GRs） and circular strain（GCs） of the short axis were measured in 36 type 2 diabetes mellitus patients with their left ventricular ejection fraction ≥ 50% and 41 normal controls through the left ventricular short axis mistral valve and at apex lecel to reverse the point of peak（LVtw）.Results The average GLs of the long axis,and the GRs and GCs of the short axis were significantly lower in type 2 diabetes mellitus patients than in normal controls（P〈0.01）,but no significant difference was found in the average GRs of the left ventricular short axis between type 2 diabetes mellitus patients and normal controls（P〈0.05）.The left ventricular GCs was lower while the left ventricular rotation and torsion angles were greater in diabetes mellitus patients than in normal controls（P〈0.05）.The GLs,GRs,GCs and LVtw were significantly correlated with LVEF in type 2 diabetes mellitus patients and normal controls.GLs and GCs in normal controls are the independent predictors for LVEF for which the regression equation = 29.81-1.5GLs-0.91GCs（P〈0.01）.GLs in diabetes mellitus patients is the independent predictor for LVEF for which the regression equation =31.83-2.72GLs（P〈0.01）.Conclusion Ultrasound STI can assess the local and global systolic dysfunction of left ventricles in type 2 diabetic mellitus patients.