三维斑点追踪技术评价2型糖尿病及慢性肾功能不全患者左心室整体收缩功能

Evaluation of Left Ventricular Systolic Function in Patients with Type 2 Diabetes Mellitus and Chronic Kidney Failure by Three-dimensional Speckle Tracking Imaging

目的:采用实时三维斑点追踪技术(3-dimensional Speckle Tracking Imaging,3D-STI)评价2型糖尿病(T2DM)及慢性肾功能不全患者(CRF)的左心室整体收缩功能。方法:收集2015年6月-2016年6月本院T2DM及CRF患者91例,分为T2DM无CRF组30例,CRF无T2DM组33例,T2DM合并CRF组28例,另选35例健康志愿者为对照组。采集左心室全容积图像,应用3D-STI技术,获得各组左心室整体纵向收缩期峰值应变(GLS),左心室整体径向收缩期峰值应变(GRS)、左心室整体圆周收缩期峰值应变(GCS)、左心室整体面积收缩期峰值应变(GAS),左心室射血分数(LVEF),比较各组指标间的差异。结果:与对照组比较,T2DM无CRF组、CRF无T2DM组、T2DM合并CRF组的GLS、GRS、GAS、GCS均减低,差异均有统计学意义(P<0.05);与T2DM无CRF组、CRF无T2DM组比较,T2DM合并CRF组的GLS、GRS、GAS、GCS均减低,差异均有统计学意义(P<0.05);T2DM无CRF组与CRF无T2DM组比较,上述参数差异均无统计学意义(P>0.05)。结论:采用3D-STI可早期、敏感的评估T2DM及CRF患者的左心室收缩功能的变化及心肌的损伤情况。T2DM及CRF患者左心室收缩功能及心肌均有损害,而T2DM合并CRF患者,其心肌损害进一步加重。

Objective： To analyze the left ventricular global systolic function with 3D speckle tracking imaging （ 3D-STI ） in patients with type 2 diabetes mellitns and chronic kidney failure.Method： From June 2015 to June 2016, 91 T2DM and CRF patients were collected, and divided into T2DM without CRF group （ 30 patients ）, CRF without T2DM group （ 33 patients ）, T2DM combined with CRF group （ 28 patients ） .Another 35 healthy volunteers were selected as the control group at the same time.The full-volume images of left ventficular were recorded.Left ventrieular ejection fraction （ LVEF ）, global longitudinal strain （ GLS ）, circumferential strain （ GCS ）, area strain （ GAS ）, and radial strain （ GRS ） were measured by 3D-STI, the index of differents groups were compared.Result： Compared with the control group, GLS, GAS, GCS and GRS of T2DM without CRF group, CRF without T2DM group, T2DM with CRF group were lower, the differences were statistically significant （P〈O.05） .Compared with T2DM without CRF group and CRF without T2DM group, GLS, GAS, GCS, GRS of T2DM combined with CRF group were lower, the differences were statistically significant （ P〈0.05 ） .Between T2DM without CRF group and CRF without T2DM group, GLS, GAS, GCS and GRS had no statistical difference （P〉0.05） .Conclusion： 3D-STI can evaluate the left ventricular systolic function and myocardial damage objectively and early, left ventricular systolic function and myocardial damage both has damage in T2DM without CRF and CRF without T2DM patients, and patients with T2DM and CRF have a further deterioration.