四维斑点追踪显像评价高血压对糖尿病患者左心房功能影响的研究

Evaluation of the effect of hypertension on left atrial function in patients with diabetes mellitus using four-dimensional speckle tracking imaging

目的探讨四维斑点追踪显像(4D-STI)评价高血压对糖尿病患者左心房功能的影响。方法回顾性选择2021年1月至12月杭州市临平区第一人民医院收治入院的2型糖尿病患者95例,合并高血压(合并高血压组)57例,未合并高血压(未合并高血压组)38例,健康体检者65人为对照组。采用4D-STI比较各组心室舒张末期左心房容积(LAVd)、心室收缩末期左心房容积(LAVs)、左心房射血前期容积(LAVp)、左心房每搏排血容积(LAEV)、左心房被动排血容积(LAPV)、左心房主动排血容积(LAAV)、左心房射血分数(LAEF)、左心房被动排血分数(LAPEF)、左心房主动排血分数(LAAEF),左心房储备期纵向应变(LALSr)、左心房储备期圆周应变(LACSr)、左心房管道期纵向应变(LALScd)、左心房管道期圆周应变(LACScd)、左心房收缩期纵向应变(LALSct)、左心房收缩期圆周应变(LACSct)。结果合并高血压组、未合并高血压组的LAVd、LAVp、LAAV高于对照组,LAPV、LAEF、LAPEF小于对照组,差异均有统计学意义(均P<0.05)。合并高血压组的LAVs高于对照组、未合并高血压组,LAVd、LAVp、LAAV高于未合并高血压组,LAEF、LAPEF小于未合并高血压组,差异均有统计学意义(均P<0.05)。3组对象的LALSr、LACSr、LALScd、LACScd比较差异均有统计学意义(均P<0.05),合并高血压组、未合并高血压组上述指标均低于对照组,差异均有统计学意义(均P<0.05)。结论利用4D-STI能够评价高血压对糖尿病患者左心房功能的影响。

Objective To evaluate the effect of hypertension on left atrial(LA)function in patients with diabetes mellitus(T2DM)using four-dimensional speckle tracking imaging.Methods A total of 95 T2DM patients admitted to the First People's Hospital of Linping District(Linping Campus,Second Affiliated Hospital,Zhejiang University School of Medicine)from January to December 2021 were included retrospectively.Among them,57 patients had hypertension(combined hypertension group)and 38 patients had no hypertension(non combined hypertension group).Sixty-five healthy individuals underwent physical examination were included as a control group.The four-dimensional speckle tracking imaging were analyzed off-line.The end-diastolic LA volume(LAVd),end-systolic LA volume(LAVs),LA pre-ejection volume(LAVp),and LA output volume per stroke(LAEV),LA passive output volume(LAPV),LA active output volume(LAAV),LA ejection fraction(LAEF),LA passive output fraction(LAPEF),LA active output fraction(LAAEF),LA longitudinal strain in reserve phase(LALSr),LA circumferential strain in reserve phase(LACSr),LA Longitudinal strain in conduit phase(LALScd)and circumferential strain in conduit phase(LACScd),LA longitudinal strain in contraction phase(LALSct),LA circumferential strain in contraction phase(LACSct)were compared among groups Results LAVd,LAVp and LAAV were significantly higher in the combined hypertension group and T2D group than in the control group,while LAPV,LAEF and LAPEF were significantly lower than in the control group(all P<0.05).The LAVs in the combined hypertension group were higher than those in the control group and non combined hypertension group,LAVd,LAVp,and LAAV were significantly higher than those in non combined hypertension group,LAEF and LAPEF were significantly lower than those in non combined hypertension group(all P<0.05).LALSr,LACSr,LALScd,and LACScd were significantly different among the three groups,and were significantly lower in the combined hypertension group and T2DM group than in the control group(all P<0.05).Conclusion Four-dimensional speckle tracking imaging can be used to evaluate the effects of hypertention on LA function of T2DM patients.