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应用超声实时三平面斑点追踪成像技术(RT-3PSTI)评价糖尿病(DM)患者左室长轴方向整体收缩功能。病例组为临床确诊为2型DM且左室射血分数(LVEF)正常的患者,根据糖化血红蛋白(HbA1c)控制水平,分为DM1(HbA1c<7%,31例)和DM2(HbA1c≥7%,37例)两组,对照组63例。采用RT-3PSTI,应用自动功能成像软件分析心尖三切面纵向收缩期峰值应变(GLPS),包括心尖四腔心GLPS(GLPS-A4C)、心尖两腔心GLPS(GLPS-A2C)、心尖左室长轴GLPS(GLPS-LAX)及平均GLPS(GLPS-Avg)。结果显示临床基线资料在三组间无统计学差异(P>0.05);DM1、DM2组的室壁厚度及心肌质量指数与对照组相比均有统计学差异(P<0.05);左室内径、容积及LVEF在三组之间无统计学差异(P>0.05);DM2组的GLPS-LAX、GLPS-A2C、GLPS-Avg与DM1组及对照组相比均有统计学差异(P<0.05),GLPS-A4C与对照组相比有统计学差异(P<0.05);DM1组的各应变测值与对照组相比差异均无统计学意义(P>0.05)。RT-3PSTI可准确评价长轴方向左室整体收缩功能,并可早期发现血糖控制不佳的DM患者亚临床的左室收缩功能减低。
The application of real-time three-plane speckle tracking imaging (RT-3PSTI) was used to evaluate the overall left ventricular systolic function in diabetic patients. The patients were divided into DM1 (HbA1c <7%, 31 cases) and DM2 (HbA1c≥7%) according to the control level of HbA1c in patients with type 2 DM and normal left ventricular ejection fraction (LVEF) , 37 cases) two groups, the control group of 63 cases. The apical triaxial longitudinal systolic peak strain (GLPS) was analyzed by RT-3PSTI software, including GLPS-GLP (GLPS-A4C), GLPS-A2C Axis GLPS (GLPS-LAX) and average GLPS (GLPS-Avg). The results showed that there was no significant difference between the three groups in clinical baseline data (P> 0.05). The wall thickness and myocardial mass index in DM1 and DM2 groups were significantly different from those in control group (P <0.05) (P <0.05). There was no significant difference in volume and LVEF between the three groups (P> 0.05). There were significant differences in GLPS-LAX, GLPS-A2C and GLPS-Avg between DM2 group and DM1 group ), There was a significant difference between GLPS-A4C and control group (P <0.05). There was no significant difference between DM1 group and control group (P> 0.05). RT-3PSTI can accurately assess the long axis of left ventricular global systolic function, and early detection of poor blood glucose control in patients with sub-clinical subclinical LV systolic function decreased.