二维斑点追踪技术评价前驱糖尿病患者的左心房功能

Evaluation of Left Atrial Function in Patients with Prediabetes by Two-Dimensional Speckle Tracking Echocardiography

目的采用二维斑点追踪技术评价空腹血糖受损或葡萄糖耐量降低的前驱糖尿病(PD)患者的左心房功能。方法选取PD患者60例作为PD组,健康成年人40例作为对照组。所有受试者均进行空腹血糖、口服葡萄糖耐量试验和糖化血红蛋白分析。采用常规超声心动图评价左心室舒张和收缩功能。采用二维斑点追踪技术测量左心房储备期纵向应变和应变率(LASr和LASRr)、通道期纵向应变和应变率(LAScd和LASRcd)以及收缩期纵向应变和应变率(LASct和LASRct),分别评价左心房储备功能、通道功能和泵功能。结果与对照组比较,PD组患者mitrale'减小(P<0.05),而mitralE/e'增大(P<0.05)。2组比较,左心室射血分数无统计学差异(P>0.05),左心房整体射血分数、主动射血分数和被动射血分数无统计学差异(P>0.05)。与对照组比较,PD组患者LAScd和LASRcd减低(P<0.05)。HbA1c与LAScd呈负相关(r=-0.69,P<0.05),与LASRcd呈正相关(r=0.57,P<0.05)。结论PD患者左心房通道功能和左心室舒张功能均减低,且左心房通道功能与糖化血红蛋白水平密切相关。

Objective To evaluate left atrial function in prediabetes( PD) patients with impaired fasting plasma glucose( FPG) or impaired glucose tolerance using two-dimensional speckle tracking echocardiography.Methods Sixty patients with PD were selected as the PD group;and 40 healthy individuals,as the control group.FPG,oral glucose tolerance,and glycosylated hemoglobin( HbA1c) analyses were performed for all the patients.Left ventricular diastolic and systolic functions were assessed using conventional echocardiography. Left atrial longitudinal strain and strain rate during the reserve( LASr and LASRr,respectively),conduit( LAScd and LASRcd,respectively), and contraction periods( LASct and LASRct,respectively) were measured using two-dimensional speckle tracking echocardiography. Results Mitral e' was smaller( P < 0.05) and mitral E/e' was greater in the PD group than in the control group( P < 0.05).No significant difference in left ventricular ejection fraction was found between the two groups( P > 0.05).No significant differences in total ejection fraction,active ejection fraction,and passive ejection fraction were found between the two groups( P > 0.05).Compared with the control group,LAScd and LASRcd were smaller in the PD group( P < 0.05).HbA1c level negatively correlated with LAScd( r =-0.69,P < 0.05) and positively correlated with LASRcd( r = 0.57,P < 0.05).Conclusion Left atrial and left ventricular diastolic functions were decreased in the PD patients,and left atrial conduit function was closely related to HbA1c level.