摘要
目的 探讨应用实时三维超声心动图(RT-3DE)评估 2 型糖尿病(T2DM)患者左心室收缩运动同步性.方法 选取 60 例T2DM患者作为观察组,分为未合并微血管病变(DM 1 组)30 例、合并微血管病变(DM 2 组)30 例,同时纳入 30 例健康志愿者为对照组.比较三组常规二维超声心动图参数和RT-3DE参数:左心室 16 节段达最小收缩容积时间的标准差和最大差值(Tmsv 16-SD、Tmsv 16-Dif),用R-R间期标化校正,记录Tmsv 16-SD/R-R、Tmsv 16-Dif/R-R,并分析DM 1 组、DM 2 组Tmsv 16-SD/R-R、Tmsv 16-Dif/R-R与 3D-LVEF的相关性.结果 DM 1 组Tmsv 16-SD、Tmsv 16-Dif、Tmsv 16-SD/R-R、Tmsv 16-Dif/R-R均高于对照组,DM 2 组 3D-LVESV、3D-LVEF均低于对照组,3D-LVSV、Tmsv 16-SD、Tmsv 16-Dif、Tmsv 16-SD/R-R、Tmsv 16-Dif/R-R均高于对照组,差异均有统计学意义(P<0.05).DM 2 组 3D-LVEF低于DM 1 组,3D-LVSV、Tmsv 16-SD、Tmsv 16-Dif、Tmsv 16-SD/R-R、Tmsv 16-Dif/R-R均高于DM 1 组,差异均有统计学意义(P<0.05).DM 1 组、DM 2 组Tmsv 16-SD/R-R、Tmsv 16-Dif/R-R与 3D-LVEF呈负相关(DM 1 组r=-0.682、-0.631,DM 2组r=-0.717、-0.634,P<0.05).结论 T2DM造成左心室舒张、收缩功能受损,RT-3DE可早期检测左心室心肌收缩运动同步性,评估左心室功能受损程度.
Abstract
Objective To evaluate the left ventricular systolic synchronization in patients with type 2 diabetes mellitus(T2DM)by real-time three-dimensional echocardiography(RT-3DE).Methods A total of 60 patients with T2DM were di-vided into two groups:DM 1 group(without microangiopathy,30 cases)and DM 2 group(with microangiopathy,30 cases),other 30 healthy adults were included into control group.We compared their two-dimensional ultrasonic parameters and RT-3DE parameters,i.e.,the time to minimal systolic volume of 16-segmental standard deviation and maximum difference(Tmsv 16-SD,Tmsv 16-Dif).Cardiac cycle was standardized,Tmsv 16-SD/R-R and Tmsv 16-Dif/R-R were got,and the correlation between Tmsv 16-SD/R-R,Tmsv 16-Dif/R-R and 3D-LVEF was analyzed.Results Tmsv 16-SD,Tmsv 16-Dif,Tmsv 16-SD/R-R,Tmsv 16-Dif/R-R in DM 1 group were significantly increased than those of the control group(P＜0.05),3D-LVESV,3D-LVEF were sig-nificantly decreased and 3D-LVSV,Tmsv 16-SD,Tmsv 16-Dif,Tmsv 16-SD/R-R,Tmsv 16-Dif/R-R in DM 2 group were signifi-cantly increased than those of the control group(P<0.05).3D-LVEF was significantly decreased and 3D-SV,Tmsv 16-SD,Tmsv 16-Dif,Tmsv 16-SD/R-R,Tmsv 16-Dif/R-R were significantly increased in DM 2 group than those of the DM 1 group(P<0.05).Tmsv 16-SD/R-R and Tmsv 16-Dif/R-R were negatively correlated with 3D-LVEF(r=-0.682,-0.631 in DM 1 group,r=-0.717,-0.634 in DM 2 group,P<0.05).Conclusion T2DM can impair left ventricular diastolic and systolic function.RT-3DE can detect left ventricular systolic synchronization in patients with T2DM and evaluate the degree of left ventricular dysfunction.
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