二维斑点追踪技术和实时三维超声心动图对糖尿病患者左心房功能的评估价值

Evaluation of Left Atrial Function in Diabetic Patients by Two-dimensional Speckle Tracking Technology and Real-time Three-dimensional Echocardiography

目的探讨二维斑点追踪技术(2D-ST1)和三维超声心动图(RT-3DE)对糖尿病(DM)患者左心房功能的评估价值。方法选择DM患者59例为观察组,健康者48例为对照组,对比两组常规超声心动图参数、RT-3DE参数、2D-STI参数。结果观察组的左心室舒张末容积(LVEDV)、左心室射血分数(LVEF)均低于对照组(P<0.05);两组二尖瓣舒张早期与晚期血流速度(mitral,E;mitral,A),三尖瓣反流峰值速度(TRPV)对比差异无统计学意义(P>0.05);观察组的左心房最小容积(LAVmin)、左心房最大容积(LAVmax)、左心房收缩前容积(LAVpre)均高于对照组,主动射血分数(LAAEF)、总射血分数(LATEF)、被动射血分数(LAPEF)均低于对照组(P<0.05);观察组的心肌应变率(SR)、左心室收缩期左心房峰值应变率(SRs)、左心室舒张早期左心房峰值应变率(SRe)、心房收缩期左心房峰值应变率(SRa)均低于对照组(P<0.05)。结论2D-STI可更为准确地发现左心房通道、储器及助力泵功能的改变,3D-STI能够准确地追踪左心房心内膜在三维空间上的运动和形变。

Objective To explore the evaluation value of two-dimensional speckle tracking technology(2D-ST1)and three-dimensional echocardiography(RT-3DE)for left atrial function in patients with diabetes(DM).Methods 59 patients with DM were selected as the observation group,and 48 healthy subjects were selected as the control group during the same period.The conventional echocardiographic parameters 2D-ST1 parameters and RT-3DE parameters of the two groups were collected and compared.Results The left ventricular end diastolic volume(LVEDV)and left ventricular ejection fraction(LVEF)of the observation group were lower than those of the control group(P<0.05).There was no significant difference in the early mitral valve diastolic blood flow velocity(mitral,E),late diastolic blood flow velocity(mitral,A)and peak tricuspid regurgitation velocity(TRPV)between the two groups(P>0.05).The minimum left atrial volume(LAVmin),the maximum left atrium volume of the observation group(LAVmax)and left atrial pre-systolic volume(LAVpre)of the observation group were higher than those of the control group.Meanwhile,the active ejection fraction(LAAEF),total ejection fraction(LATEF),and passive ejection fraction(LAPEF)of the observation group were lower than those of the control group(P<0.05).The observation group's myocardial strain rate(SR),left ventricular peak strain rate(SRs)during left ventricular systole,left ventricular peak strain rate(SRe)during early diastole,and left atrial peak strain rate(SRa)during atrial systole were lower than those of the control group(P<0.05).Conclusion Compared with conventional echocardiography,both 2D-STI and RT-3DE can detect the changes of left atrial function and myocardial structure in DM patients earlier.However,2D-STI can more accurately detect the changes in the function of the left atrium channel,reservoir and booster pump,and 3D-STI can accurately track the movement and deformation of the left atrium endocardium in three-dimensional space.