三维斑点追踪成像评价糖尿病患者心脏损害的Meta分析

Assessment of left ventricular function by three-dimensional speckle tracking imaging in patients with diabetes mellitus:Meta analysis

目的评价三维斑点追踪成像(3D-STI)定量测评糖尿病(DM)患者左心室应变的临床价值。方法计算机检索PubMed等数据库官方网站中2016年8月1日之前发表的有关3D-STI评价DM患者左心室功能的病例对照研究。确切的纳入与排除标准制定后,独立筛选文献、提取各项数据和评价质量分配给2名两名研究员。通过Stata 12.0软件分析权重均数差(WMD)及95%可信区间(CI)。结果最终纳入12篇病例对照研究,共计620例DM患者和473名正常者。Meta分析:DM组与对照组左心室射血分数的差异无统计学意义[WMD=-0.94,95%CI(-1.92,-0.04),P=0.06];左心室整体应变DM组与对照组相比差异均有统计学意义:径向应变[WMD=-3.63,95%CI(-5.15,-2.11),P<0.01]、纵向应变[WMD=3.54,95%CI(2.71,4.36),P<0.01]、环向应变[WMD 2.48,95%CI(1.49,3.48),P<0.01]、面积应变[WMD=2.92,95%CI(2.33,3.50),P<0.01)。结论 3D-STI定量测评糖尿病群体的左心室应变指标具有一定的临床价值。

Objective To evaluate the value of three-dimensional speckle tracking imaging （3D-STI） for left ventricular systolic function in diabetes mellitus （DM） patients with Meta analysis. Methods Published case-control studies comparing the left ventricular systolic function assessed by 3D-ST1 of DM patients and controls were searched before August 1, 2016. Crude weighted mean difference （WMD） with 95 % confidence intervals （95 %CI） were used to analysis the differences between DM patients and healthy controls. Results Twelve studies were included with total of 620 patients and 473 healthy control participants. Meta analysis revealed that the diffierence of left ventricular rejection fraction （LVEF） between DM group and control group was not statistically significant （WMD=- 0.94, 95% CI [-1.92, -0.04], P = 0.06）. The left ventrieular systolic function global radial strain （GRS, WMD= - 3. 63, 95%CI [-5.15, -2.11], P〈 0.01）, global longitudinal strain （GLS, WMD =3. 54, 95%CI [2.71, 4.36], P〈0.01）, global circumferential stain （GCS, WMD 2. 48, 95%CI [1.49, 3.48], P〈0.01） and global area strain （GAS, WMD=2.92, 95%CI [-2.33, 3.50], P〈0. 001） had significant differences between DM patients and the controls. Conclusion 3D-STI has clinical values in evaluation left ventricular function in patients with DM.