| 杨清,冉海涛,刘凤琴.实时三维超声心动图评价2型糖尿病及代谢综合征患者左心室功能及同步性[J].中国医学影像技术,2016,32(5):727~731 |
| 实时三维超声心动图评价2型糖尿病及代谢综合征患者左心室功能及同步性 |
| Assessment of left ventricular function and synchrony in patients with type 2 diabetes and metabolic syndrome with real-time three-dimensional echocardiography |
| 投稿时间：2015-09-21 修订日期：2016-03-06 |
| DOI：10.13929/j.1003-3289.2016.05.024 |
| 中文关键词: 糖尿病,2型 代谢综合征 心室功能,左 超声心动描记术 |
| 英文关键词:Diabetes mellitus, type 2 Metabolic syndrome Ventricular function, left Echocardiography |
| 基金项目:国家自然科学基金面上项目(81471713)。 |
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| 中文摘要: |
| 目的 采用实时三维超声心动图(RT-3DE)评价2型糖尿病(T2DM)及代谢综合征(MS)患者的左心室功能及同步性,并探讨MS各分组与RT-3DE测量的左心室射血分数(3D-EF)及收缩不同步指数(SDI)的相关性。方法 收集T2DM及MS患者95例,根据国际糖尿病联盟(IDF)标准及T2DM诊断标准分为MS无T2DM组、T2DM无MS组和MS合并T2DM组,另选40名健康志愿者为对照组。采集左心室全容积图像,采用RT-3DE分析软件,获左心室舒张末期容积(EDV)、收缩末期容积(ESV)、3D-EF及同步性参数(Tmsv16-SD%、Tmsv12-SD%、Tmsv6-SD%、Tmsv16-Dif%、Tmsv12-Dif%、Tmsv6-Dif%)。其中Tmsv16-SD%为SDI。结果 与对照组比较,MS无T2DM组、T2DM无MS组、MS合并T2DM组的ESV、Tmsv16-SD%、Tmsv12-SD%、Tmsv6-SD%、Tmsv16-Dif%、Tmsv12-Dif%升高,3D-EF减低(P均<0.05)。与MS无T2DM组、T2DM无MS组比较,MS合并T2DM组患者Tmsv16-SD%、Tmsv12-SD%、Tmsv16-Dif%、Tmsv6-Dif%升高,3D-EF减低(P<0.05);MS无T2DM组与T2DM无MS组间RT-3DE参数差异无统计学意义(P>0.05)。腹围(WC)、收缩压(SBP)、空腹血糖(FBG)与3D-EF(r=-0.57、-0.52、-0.46,P均<0.05)呈负相关,与SDI呈正相关(r=0.48、0.63、0.55,P均<0.05)。结论 采用RT-3DE可准确评估T2DM及MS患者的左心室功能及同步性变化。MS无T2DM患者、T2DM无MS患者左心室功能及同步性损害相似,而MS合并T2DM患者损害进一步加重;WC、SBP、FBG是影响左心室的功能及同步性的主要因素。 |
| 英文摘要: |
| Objective To evaluate left ventricular function and synchrony with real-time three-dimensional echocardiography (RT-3DE) in patients with type 2 diabetes (T2DM) and metabolic syndrome (MS), and explore the correlation between MS criteria and left ventricular ejection fraction detected by RT-3DE (3D-EF) and systolic dyssynchrony index (SDI). Methods Totally 95 patients were divided into three groups according to the international diabetes foundation (IDF) criteria and the diagnostic criteria of T2DM, named MS without T2DM group, T2DM without MS group and MS with T2DM group. And 40 healthy volunteers were enrolled as normal controls (control group). The full-volume images of left ventricular are recorded and analyzed by RT-3DE analysis software. Left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), 3D-EF and synchronic parameters (Tmsv16-SD%, Tmsv12-SD%, Tmsv6-SD%, Tmsv16-Dif%, Tmsv12-Dif%, Tmsv6-Dif%) were calculated. Among them Tmsv16-SD% was SDI. Results Compared with the control group, ESV, Tmsv16-SD%, Tmsv12-SD%, Tmsv6-SD%, Tmsv16-Dif%, Tmsv12-Dif% increased, and 3D-EF decreased in other three groups (all P<0.05). Compared with MS without T2DM and T2DM without MS group, Tmsv16-SD%, Tmsv12-SD%, Tmsv16-Dif%, Tmsv6-Dif% increased, 3D-EF decreased in MS with T2DM group (all P<0.05). Between MS without T2DM and T2DM without MS group, RT-3DE parameters had no statistical differences (all P>0.05). Waist circumference (WC), systolic blood pressure (SBP), fasting blood-glucose (FBG) and 3D-EF were negatively correlated (r=-0.57, -0.52, -0.46, all P<0.05), and positively correlated with SDI (r=0.48, 0.63, 0.55, all P<0.05). Conclusion RT-3DE can assess left ventricular function and synchrony in patients with T2DM and MS sensitively. Patients having MS without T2DM and T2DM without MS have a similar impairment of left ventricular function and synchrony, whereas patients with MS and T2DM have a further deterioration. WC, SBP, FBG are main factors in impact on LV function and synchrony. |
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