超声心动图在长病程T2DM患者心功能损害评估中的应用

Application of echocardiogram in evaluation of cardiac function impairment in patients with long-course T2DM

目的:探讨超声心动图在长病程2型糖尿病(T2DM)患者心功能损害评估中的应用价值。方法:选取2021年5月-2023年6月在本院诊治的90例长病程T2DM患者,根据患者是否并发心功能损害将其分为未并发组(n=42)和并发组(n=48)。所有受试者均接受超声心动图检测。比较T2DM患者的超声心动图参数,比较未并发组和并发组患者的临床资料和影像学指标,采用Logistic回归分析影响长病程T2DM患者并发心功能损害的危险因素,并采用受试者工作特征(ROC)曲线分析超声心动图参数对长病程T2DM患者并发心功能损害的评估效能。结果:未并发组和并发组性别、收缩压和舒张压比较,差异无统计学意义(P>0.05)。未并发组和并发组年龄、空腹血糖、左心房容积指数(LAVI)、二尖瓣口血流速度比值(E/A)、左心室射血分数(LVEF)和左心室整体纵向峰值应变(GLS)水平比较,差异均有统计学意义(P<0.05)。Logistic回归结果显示:患者LAVI升高、LVEF降低和GLS降低是并发心功能损害的独立影响因素(P<0.05)。ROC结果显示:LAVI、LVEF和GLS检测的ROC下曲线面积为0.781、0.676、和0.796,其临界值分别为30.302、63.514%和-15.452,预测价值中等(P<0.05)。结论:超声心动图在长病程T2DM患者并发心功能损害中具有较好的评估效能。

Objective:To explore the application value of echocardiogram in evaluating cardiac function impairment in patients with long-course type 2 diabetes mellitus(T2DM).Methods:A total of 90 patients with long-course T2DM in the hospital were enrolled between May 2021 and June 2023.According to presence or absence of cardiac function impairment,they were divided into concurrence group(n=42)and non-concurrence group(n=48).All patients underwent echocardiography.The echocardiogram parameters,clinical data and imaging indexes in the two groups were compared.The risk factors of cardiac function impairment were analyzed by Logistic regression analysis.The evaluation efficiency of echocardiogram parameters for cardiac function impairment was analyzed by receiver operating characteristic(ROC)curves.Results:There was no significant difference in gender,systolic blood pressure or diastolic blood pressure between non-concurrence group and concurrence group(P>0.05),but there were significant differences in age,fasting blood glucose,left atrial volume index(LAVI),ratio of early blood flow peak velocity to end-diastolic peak blood flow velocity(E/A),left ventricular ejection fraction(LVEF)and left ventricular global longitudinal strain(GLS)between the two groups(P<0.05).The results of Logistic regression analysis showed that increased LAVI,decreased LVEF and GLS were independent influencing factors of cardiac function impairment(P<0.05).The results of ROC curves analysis showed that area under the curve(AUC)and cut-off values of LAVI,LVEF and GLS for predicting cardiac function impairment were(0.781,0.676,0.796)and(30.302,63.514%,-15.452),showing general predictive value(P<0.05).Conclusion:The evaluation efficiency of echocardiogram is good for cardiac function impairment in patients with long-course T2DM.