| 金鑫,韩东刚,周琦,魏亚娟,李谦.三维超声心动图评价糖尿病患者左心室功能及其与血清学代谢指标的相关性[J].中国医学影像技术,2018,34(7):1009~1013 |
| 三维超声心动图评价糖尿病患者左心室功能及其与血清学代谢指标的相关性 |
| Three-dimensional echocardiographic assessment of left ventricular function and correlation with metabolic indexes in patients with diabetes |
| 投稿时间：2017-11-08 修订日期：2018-03-29 |
| DOI：10.13929/j.1003-3289.201711050 |
| 中文关键词: 超声心动描记术,三维 糖尿病 心室功能,左 |
| 英文关键词:Echocardiography,three-dimensional Diabetes Ventricular function,left |
| 基金项目:陕西省重点研发计划项目（S2017-ZDYF-YBXM-SF-0183）。 |
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| 中文摘要: |
| 目的 探讨应用三维超声心动图评价糖尿病患者早期左心室功能改变及其指标与血清学代谢指标的相关性。方法 收集90例2型糖尿病患者[早期糖尿病患者48例（早期糖尿病组）、早期糖尿病肾病患者42例（早期糖尿病肾病组）]和47名健康志愿者（对照组）。以二维超声心动图测量左心室舒张末期内径（LVEDd）、左心室收缩末期内径（LVESd）、二维左心室射血分数（2D-LVEF）、等容舒张时间（TVRT）、二尖瓣口舒张早期血流速度（Ea）、二尖瓣口舒张晚期血流速度（Aa）和E峰下降时间（EDT），并计算E/E'值及左心室Tei指数；以实时三维超声心动图测量左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、三维左心室射血分数（3D-LVEF）及左心室心肌层整体纵向应变（GLS）。记录血清胱抑素C、β2微球蛋白、血肌酐及糖化血红蛋白水平，比较3组间上述指标的差异，并评价超声心动图指标与血清学指标间的相关性。结果 与对照组比较，早期糖尿病组LVEDV、E/E'、Tei指数增高，3D-LVEF及GLS降低（P均<0.05）；早期糖尿病肾病组LVDd、LVEDV、LVESV、Tei指数、E/E'、Aa、IVRT及EDT增高，2D-LVEF、GLS、3D-LVEF及Ea降低（P均<0.05）。与早期糖尿病组比较，早期糖尿病肾病组LVDd、LVEDV、Tei指数、E/E'及EDT增高，GLS及3D-LVEF降低（P均<0.05）。相关性分析显示，血清β2微球蛋白与Tei指数、LVEDV呈正相关（r=0.732、0.604，P均<0.05），与GLS呈负相关（r=-0.703，P<0.05）；糖化血红蛋白水平与LVEDV呈正相关（r=0.663，P<0.05），与3D-LVEF、GLS呈负相关（r=-0.701、-0.742，P均<0.05）。结论 糖尿病患者早期左心室舒张及收缩功能均受损，其左心室功能与血清β2微球蛋白及糖化血红蛋白水平具有相关性。 |
| 英文摘要: |
| Objective To assess the left ventricular dysfunction and the correlation with metabolic indexes in diabetes patients with real-time three-dimensional echocardiography.Methods Totally 90 patients with type 2 diabetes (48 with early-stage diabetes[early diabetes group], 42 with early-stage diabetic nephropathy[early diabetic nephropathy group]) and 47 healthy volunteers (control group) were enrolled. The left ventricular end-diastolic dimension (LVEDd), left ventricular end-systolic diameter (LVESd), two-dimensional left ventricular ejection fraction (2D-LVEF), isovolumic relaxation time (TVRT), early diastolic velocity of mitral valve (Ea), end diastolic velocity of mitral valve (Aa) and E-wave deceleration time (EDT) were measured with two-dimensional echocardiography. E/E' and Tei index were calculated. Real-time three-dimensional ultrasound was used to record the left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), three-dimensional left ventricular ejection fraction (3D-LVEF) and left ventricular myocardium overall longitudinal strain (GLS). The serum cystatin C, β2 microglobulin, serum creatinine and glycated hemoglobin levels were recorded. The differences of the above indicators were compared among 3 groups, and the correlation between echocardiographic indicators and serological indicators were evaluated.Results Compared with those of control group, LVEDV, E/E', Tei index increased, 3D-LVEF and GLS decreased in early diabetes group (all P<0.05), while LVDd, LVEDV, LVESV, Tei index, E/E', Aa, IVRT and EDT increased, 2D-LVEF, GLS, 3D-LVEF and Ea decreased in early diabetic nephropathy group (all P<0.05). Compared with those of early diabetes group, LVDd, LVEDV, Tei index, E/E' and EDT increased, GLS and 3D-LVEF decreased in patients with early diabetic nephropathy group (all P<0.05). Correlation analysis showed that serum β2 microglobulin positively correlated with Tei index and LVEDV (r=0.732, 0.604, both P<0.05), and negatively correlated with GLS (r=-0.703, P<0.05). The glycated hemoglobin level positively correlated with LVEDV (r=0.663, P<0.05) and negatively correlated with 3D-LVEF and GLS (r=-0.701, -0.742, both P<0.05).Conclusion The diastolic and systolic function of the left ventricle was impaired in early diabetic patients, and the left ventricular function is correlated with serum β2 microglobulin and glycosylated hemoglobin level. |
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