二维斑点追踪技术评价单纯腹型肥胖患者左心室整体与节段收缩功能的临床研究

Quantitative assessment of left ventricular global and segmental systolic function in patients with abdominal obesity using two-dimensional speckle tracking

目的应用二维斑点追踪技术(2D-STI)研究腹型肥胖患者左心室整体与节段纵向收缩功能,探讨其临床应用价值。方法连续选择单纯腹型肥胖患者36例(腹型肥胖组),同期选择健康体检者33例作为正常对照(健康对照组)。测量两组腰围、臀围并计算腰臀比(WHR),采用2D-STI测量左心室18节段纵向应变(SSL)、整体应变(GLS)以及颈动脉内中膜厚度(IMT),比较两组上述参数,并分析GLS与WHR的相关性。结果与对照组比较,腹型肥胖组左心室大部分节段SSL以及GLS减低(P均<0.05),IMT增加(P=0.001);相关性分析显示,腹型肥胖组GLS与WHR(r=0.723,P<0.001)、IMT(r=0.560,P=0.001)以及合并心血管危险因素数(r=0.785,P<0.001)均呈线性相关;控制心血管危险因素以及IMT,腹型肥胖组GLS与WHR仍呈线性相关(偏相关系数r=0.538,P=0.003)。结论单纯腹型肥胖患者左心室整体与节段纵向收缩功能显著受损,其受损程度与肥胖程度以及心血管危险因素显著相关。

Objective To evaluate the value of Two-dimensional Speckle Tracking（2D-STI） in the assessment of left ventricular longitudinal global and segmental systolic function in patients with abdominal obesity. Methods Thirty-six abdominal obesity cases and thirty-three healthy cases were investigated using echocardiography. Waist, hip were measured and the waist-to-hip ratio （waist-hip ratio, WHR） were calculated in the two groups. Left ventricular longitudinal segmental strain（SSL）, left ventricular global longitudinal strain（GLS）were measured by the technique of 2D-STI, IMT were measured as well. Their characteristics between patients with abdominal obesity and healthy group were compared, and the relationship of WHR and GLS were analyzed. Results In abdominal obesity group, the most SSL and GLS were significantly decreased compared with control group（P〈0.05）, and IMT were significantly increased（P=0.001）. The GLS positive related with WHR （r=0.723, P〈0.001）, IMT （r=0.560, P=0.001） and the number of cardiovascular risk factors（r=0.785, P〈0.001）. The GLS positive related with WHR independently by the analysis of partial correlation（r=0.538,P=0.003）. Conclusion Left ventricular longitudinal global and segmental systolic function are damaged in patients with abdominal obesity. The degree of damage on left ventricular systolic function relate with degree of abdominal obesity and cardiovascular risk factors.