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目的探讨二维斑点追踪成像技术在2型糖尿病合并高血压患者左心室功能评估中的价值。方法选择2013年12月—2015年12月金华市中心医院2型糖尿病合并高血压患者87例作为观察组,选择同期健康体检者87例作为对照组,超声心动图测量2组患者的左心室参数,二维斑点追踪成像技术测定2组患者左心室心尖各切面纵向的应变值。结果观察组和对照组患者左室射血分数、舒张期左室后壁厚度、舒张期室间隔厚度和左室内径之间比较差异没有统计学意义(P>0.05),观察组舒张期二尖瓣口E峰/A峰(0.98±0.17)低于对照组(1.27±0.26,t=9.243,P<0.05)。观察组患者收缩期心尖切面左室整体、左室长轴、四腔心和两腔心的纵向应变峰值(-21.8±2.8、-22.2±2.9、-21.7±2.6、-22.2±2.9)均低于对照组(-22.9±3.2、-23.4±3.3、-23.5±2.4、-23.4±2.8,t=2.525、2.415、3.619、2.335,P<0.05)。观察组患者舒张早期心尖切面左室长轴、四腔心和两腔心的纵向应变峰值(1.19±0.13、1.20±0.14、1.16±0.23)均低于对照组(1.31±0.28、1.35±0.29、1.28±0.21,t=2.925、3.274、2.823,P<0.05)。观察组患者舒张晚期心尖切面左室长轴、四腔心和两腔心的纵向应变峰值(1.18±0.27、1.28±0.29、1.25±0.24)均高于对照组(1.07±0.22、1.17±0.23、1.15±0.18,t=3.024、2.945、2.657,P<0.05)。结论二维斑点追踪成像技术能够发现2型糖尿病合并高血压患者早期左心室功能异常。
Objective To investigate the value of two-dimensional speckle tracking imaging in assessment of left ventricular function in type 2 diabetic patients with hypertension. Methods Eighty-seven patients with type 2 diabetes mellitus complicated with hypertension in Central Hospital of Jinhua from December 2013 to December 2015 were selected as the observation group, and 87 healthy subjects at the same period were selected as the control group. Left ventricular parameters Two-dimensional speckle tracking imaging technique was used to measure the longitudinal strain of each section of the left ventricular apex in two groups. Results The left ventricular ejection fraction, diastolic left ventricular wall thickness, diastolic interventricular septum thickness and left ventricular diameter were not significantly different between observation group and control group (P> 0.05) The peak / peak A of valve orifice (0.98 ± 0.17) was lower than that of the control group (1.27 ± 0.26, t = 9.243, P <0.05). The longitudinal strain peak (-21.8 ± 2.8, -22.2 ± 2.9, -21.7 ± 2.6, -22.2 ± 2.9) in the systolic apical plane of the observation group was significantly lower (-22.9 ± 3.2, -23.4 ± 3.3, -23.5 ± 2.4, -23.4 ± 2.8, t = 2.525, 2.415, 3.619, 2.335, P <0.05) in the control group. The longitudinal strain peak (1.19 ± 0.13,1.20 ± 0.14, 1.16 ± 0.23) in the left ventricular long axis, the four-chamber heart and the two-chamber heart in the early diastolic apical section of the observation group was significantly lower than that of the control group (1.31 ± 0.28,1.35 ± 0.29, 1.28 ± 0.21, t = 2.925, 3.274, 2.823, P <0.05). In the observation group, the peak value of longitudinal strain (1.18 ± 0.27,1.28 ± 0.29,1.25 ± 0.24) in left ventricular long axis, four-chamber heart and two-chamber heart in late diastolic apical section was higher than that in control group (1.07 ± 0.22,1.17 ± 0.23, 1.15 ± 0.18, t = 3.024, 2.945, 22.657, P <0.05). Conclusion Two-dimensional speckle tracking imaging can detect early left ventricular dysfunction in patients with type 2 diabetes mellitus and hypertension.