二维斑点追踪技术评价冠心病合并2型糖尿病患者左室心肌功能的早期改变

Evaluation of left ventricular myocardial function in coronary atherosclerosis patients with type 2 diabetes mellitus by speckle tracking echocardiography

目的：应用二维斑点追踪技术（2D STE）定量评价冠心病合并2型糖尿病患者心肌功能的早期改变。方法2013年1月至2014年1月间收集首都医科大学宣武医院心脏科经冠状动脉CTA证实主要分支狭窄（＜50％）的患者60例，其中合并2型糖尿（糖尿病组）及未合并糖尿病患者（非糖尿病组）各30例；另选取30例健康人作对照组，测量左室各节段的纵向、圆周及径向的收缩期峰值应变（ε）。结果三组间左室射血分数（ EF）无差异。糖尿病组的纵向基底段、中间段及心尖段纵向收缩期峰值应变显著降低，各个阶段差异均有统计学意义（均P＜0.05）。圆周及径向运动速度指标三组间无明显差异。结论2D STE技术可以发现冠心病合并2型糖尿病患者在左室整体收缩功能出现降低之前，已存在的左室纵向心肌运动功能受损。

Objective To evaluate the left ventricular （ LV ） myocardial function in coronary atherosclerosis patients with type 2 diabetes mellitus （ DM ） by two-dimensional speckle tracking echocardiography （2D STE）.Methods A total of 60 patients with a diagnosis of coronary atherosclerosis （〈50%） were divided into DM and non-DM groups （ n=30 each）.And another 30 cases were selected as normal control group.LV regional longitudinal , circumferential and radial peak systolic strain （ε） were measured respectively.Results EF showed no difference among 3 groups.However the peak systolic longitudinal strain （ε） in LV basal segments , middle segments and apical segments were significantly lower in DM group than those in non-DM and control groups （ P〈0.05 ）.The peak systolic circumferential and radial strain parameters showed no significant difference among 3 groups.Conclusion The systolic longitudinal myocardial function of LV become compromised before reduced LV global systolic function in coronary atherosclerosis patients with type 2 diabetes mellitus.