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目的应用分层应变技术评估Ⅱ型糖尿病患者及糖耐量异常患者左心室各层心肌收缩功能的改变。方法对38例Ⅱ型糖尿病、40例糖耐量异常患者和36例正常对照者进行常规超声心动图测量,存储二维动态图像后在EchoPAC工作站进行描记分析,获得左室壁18个节段的内、中层及外层心肌的收缩期峰值圆周应变(CS)、收缩期峰值纵向应变(LPS)及整体的分层和全层应变值。结果左室整体内、中、外层及整体全层CS在3组之间的差异有统计学意义(P<0.05),整体内、中层和整体LPS在3组之间的差异有统计学意义(P<0.05),整体外层LPS在3组之间的差异无统计学意义(P>0.05);基底段内、中、外层,中间段内、中、外层CS在3组之间的差异有统计学意义(P<0.05),基底段内、中、外层,中间段内、中层LPS在3组之间的差异有统计学意义(P<0.05),心尖段三层心肌CS、LPS及中段外层心肌LPS在3组之间的差异无统计学意义(P>0.05)。结论分层应变技术可定量评价糖尿病及糖耐量异常患者左心室各层及整体心肌的收缩功能改变,对于评价糖尿病及糖耐量异常患者左心室早期改变具有一定的临床应用价值。
Objective To assess the changes of myocardial systolic function in patients with type 2 diabetes mellitus and patients with impaired glucose tolerance by stratified strain technique. Methods 38 patients with type Ⅱ diabetes mellitus, 40 patients with impaired glucose tolerance and 36 normal controls were measured by conventional echocardiography. Two-dimensional dynamic images were stored and traced in the EchoPAC workstation to obtain 18 segments of the left ventricular wall , Systolic peak circumferential strain (CS), systolic peak longitudinal strain (LPS) and global stratification and full thickness strain of the middle and outer myocardium. Results There was a statistically significant difference in the total, median, and total levels of left ventricular CS between the three groups (P <0.05). There was a statistically significant difference in overall, middle, and overall levels of LPS between the three groups (P <0.05). There was no significant difference in the total outer LPS between the three groups (P> 0.05). The basal segment middle, middle and outer segments, (P <0.05). There was significant difference between the three groups in inner, middle, outer, middle and middle basal segments of LPS (P <0.05) There was no significant difference in LPS and LPS between the three groups (P> 0.05). Conclusion Stratified strain technique can quantitatively evaluate the changes of systolic function in left ventricular layers and whole myocardium in patients with diabetes mellitus and impaired glucose tolerance, which is of clinical value in the evaluation of early changes of left ventricular in patients with diabetes mellitus and impaired glucose tolerance.