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目的应用三维斑点追踪成像(3D-STI)技术评估2型糖尿病(T2DM)患者左心室整体应变特点及其与糖化血红蛋白(Hb A1c)的关系。方法 65例T2DM患者,根据Hb A1c水平分为血糖控制良好者(A组)31例和血糖控制不良者(B组)34例,选取健康对照者(NC组)62例,采用左室全容积图像采集,Tom Tec工作站分析,得出左室整体纵向应变(GLS)、整体环向应变(GCS)、整体径向应变(GRS)、整体面积应变(GAS)、左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、左室射血分数(LVEF)等参数并比较。结果 B组GAS、GLS[(-20.38±2.63)%、(-14.68±2.84)%]较NC组[(-25.88±4.84)%、(-19.41±3.95)%]及A组[(-24.51±2.94)%、(-18.28±3.10)%]减低(P<0.05);各组LVEDV、LVESV、LVEF、GRS、GCS指标比较差异均无统计学意义(P>0.05)。Hb A1c与GAS、GLS呈负相关(P<0.01)。结论 3D-STI可客观评价T2DM患者左室收缩功能,血糖控制不佳者GLS、GAS减低可作为评价心功能受损的指标。
Objective To evaluate the global left ventricular strain characteristics and its relationship with HbA1c in patients with type 2 diabetes mellitus (T2DM) by using 3D speckle tracking imaging (3D-STI). Methods Totally 65 patients with T2DM were divided into three groups according to the level of Hb A1c, including 31 patients with well-controlled blood glucose (A group) and 34 patients with poor blood glucose control (B group). Sixty-two healthy controls (NC group) Image acquisition, analysis by Tom Tec workstation showed that left ventricular total longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), global area strain (GAS), left ventricular end-systolic volume , Left ventricular end diastolic volume (LVEDV), left ventricular ejection fraction (LVEF) and other parameters and compared. Results Compared with NC group [(-25.88 ± 4.84)%, (-19.41 ± 3.95)%] in group B and [-24.51 (P <0.05). There was no significant difference in LVEDV, LVESV, LVEF, GRS and GCS between the two groups (P> 0.05). Hb A1c was negatively correlated with GAS and GLS (P <0.01). Conclusion 3D-STI can objectively evaluate the left ventricular systolic function in patients with T2DM. The decrease of GLS and GAS in patients with poor glycemic control can be used as an index to evaluate the impairment of cardiac function.