三维斑点追踪技术评价糖尿病患者早期左心室功能

郑英娟 温德惠 刘伟亮 史宝林 谷君 徐乐 孙晨曦

[摘要] 目的 探討三维斑点追踪技术评价糖尿病患者早期左心功能。 方法 选择2017年1月～2018年4月河北北方学院附属第一医院门诊或住院的2型糖尿病患者83例，其中2型糖尿病44例（糖尿病组）、糖尿病合并高血压39例（糖尿病合并高血压组），选择同期健康人40例（对照组）。应用超声心动图测量常规参数及应用三维斑点追踪技术测量左室整体应变，包括纵向应变（GLS）、圆周应变（GCS）、面积应变（GAS）、径向应变（GRS）及三维左室射血分数（3D-LVEF），比较三组间差异。 结果 各组二维左室射血分数（2D-LVEF）等常规超声心动图测值比较，差异无统计学意义（P > 0.05）。与对照组比较，糖尿病组GLS、GAS、GCS、GRS明显降低，差异有高度统计学意义（P < 0.01），糖尿病合并高血压组GLS、GAS、GCS、GRS、3D-LVEF明显降低，差异有高度统计学意义（P < 0.01），与糖尿病组比较，糖尿病合并高血压组GLS、GAS、GRS、3D-LVEF降低，差异有统计学意义（P < 0.05）。 结论 三维斑点追踪技术在糖尿病患者2D-LVEF正常时可及早发现糖尿病心功能的改变，为临床预防糖尿病心脑血管并发症的发生提供影像学依据。

[关键词] 三维斑点追踪技术；心肌整体应变：心肌损害；糖尿病；左心功能

[中图分类号] R587.2 [文献标识码] A [文章编号] 1673-7210（2018）12（b）-0122-05

[Abstract] Objective To evaluate left ventricular function in early stage of diabetes mellitus by three-dimensional speckle tracking technique. Methods From January 2017 to April 2018， 83 patients with type 2 diabetes who were outpatient or hospitalized in the First Affiliated Hospital of Hebei North University were selected， including 44 cases of type 2 diabetes （diabetes group）， 39 cases of diabetes complicated with hypertension （diabetes complicated with hypertension group）， and 40 cases of healthy people in the same period （control group）. Conventional echocardiography and three-dimensional speckle tracking technology were used to measure the overall left ventricular strain， including global longitudinal strain （GLS）， global circumferential strain （GCS）， global area strain （GAS）， global radial strain （GRS） and three-dimensional left ventricular ejection fraction （3D-LVEF）， and the differences between the three groups were compared. Results The value of conventional echocardiography such as two-dimensional left ventricular ejection fraction（2D-LVEF） in each groups had no significant difference（P > 0.05）.Compared with the control group， GLS， GAS， GCS and GRS in the diabetes group were significantly reduced， with highly statistically significant differences （P < 0.01）. GLS， GAS， GCS， GRS and 3D-LVEF were significantly reduced in the diabetes complicated with hypertension group， and the differences were highly statistically significant （P < 0.01）. Compared with the diabetes group， GLS， GAS， GRS and 3D-LVEF in the diabetes complicated with hypertension group were decreased， and the differences were statistically significant （P < 0.05）. Conclusion Three-dimensional spot tracking technology can detect changes in diabetic heart function early when 2D-LVEF is normal in diabetic patients， providing imaging basis for clinical prevention of diabetic heart and cerebrovascular complications.