中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2012年
2期
147-152
,共6页
刘晓宇%戴敏%郑杰%张常莹%李库林%高运来%李晓燕%唐圆圆%钱大钧%王如兴
劉曉宇%戴敏%鄭傑%張常瑩%李庫林%高運來%李曉燕%唐圓圓%錢大鈞%王如興
류효우%대민%정걸%장상형%리고림%고운래%리효연%당원원%전대균%왕여흥
糖尿病,2型%心室功能,左%糖尿病神经病变
糖尿病,2型%心室功能,左%糖尿病神經病變
당뇨병,2형%심실공능,좌%당뇨병신경병변
Diabetes mellitus,type 2%Ventricular function,left%Diabetic neuropathies
目的 应用斑点追踪成像技术研究糖尿病心脏自主神经病变患者左心室功能及扭转运动,探讨其临床应用价值.方法 2型糖尿病不伴并发症患者35例(A组),2型糖尿病伴心脏自主神经病变者21例(B组),正常对照者34例(对照组).测量和计算左心室18节段圆周收缩期应变峰值、舒张早期(E′)及舒张晚期(A′)应变峰值、各水平和整体收缩期圆周应变峰值、E′/A′、收缩末期扭转角度、等容舒张末期扭转角度、解旋率和解旋减半时间.结果 与对照组相比A组患者左心室收缩期各水平及整体圆周应变差异无统计学意义(P＞0.05),但E′/A′降低(P＜0.05)、收缩末期扭转角度和等容舒张末期扭转角度增加(P＜0.05),解旋率减低(P＜0.05),解旋减半时间延迟(P＜0.05),B组患者左心室收缩期各水平及整体圆周应变较A组及对照组减弱[(-12.64±6.49)％比(-19.11 ±9.98)％和(-21.14±10.13)％,P＜0.05]、E′/A′降低[(0.90 ±0.35)比(1.24 ±0.47)和( 1.98±0.63),P＜0.05]、收缩末期扭转角度和等容舒张末期扭转角度增加[(19.08 ±5.62)°比(16.57±2.84)°和(14.36±4.06)°,(13.99 ±2.31)°比(11.36 ±2.63)°和(9.04±5.63)°,P＜0.05],解旋率减低[(0.40 ±0.28) ％/ms比(0.46 ±0.14) ％/ms和(0.53±0.21)％/ms,P＜0.05],解旋减半时间延迟[ (489.61 ±97.14)ms比(445.21±54.53) ms和(410.60±50.23) ms,P＜0.05].结论 斑点追踪成像技术能够准确评价2型糖尿病心脏自主神经病变患者左心室功能及扭转运动的异常.
目的 應用斑點追蹤成像技術研究糖尿病心髒自主神經病變患者左心室功能及扭轉運動,探討其臨床應用價值.方法 2型糖尿病不伴併髮癥患者35例(A組),2型糖尿病伴心髒自主神經病變者21例(B組),正常對照者34例(對照組).測量和計算左心室18節段圓週收縮期應變峰值、舒張早期(E′)及舒張晚期(A′)應變峰值、各水平和整體收縮期圓週應變峰值、E′/A′、收縮末期扭轉角度、等容舒張末期扭轉角度、解鏇率和解鏇減半時間.結果 與對照組相比A組患者左心室收縮期各水平及整體圓週應變差異無統計學意義(P＞0.05),但E′/A′降低(P＜0.05)、收縮末期扭轉角度和等容舒張末期扭轉角度增加(P＜0.05),解鏇率減低(P＜0.05),解鏇減半時間延遲(P＜0.05),B組患者左心室收縮期各水平及整體圓週應變較A組及對照組減弱[(-12.64±6.49)％比(-19.11 ±9.98)％和(-21.14±10.13)％,P＜0.05]、E′/A′降低[(0.90 ±0.35)比(1.24 ±0.47)和( 1.98±0.63),P＜0.05]、收縮末期扭轉角度和等容舒張末期扭轉角度增加[(19.08 ±5.62)°比(16.57±2.84)°和(14.36±4.06)°,(13.99 ±2.31)°比(11.36 ±2.63)°和(9.04±5.63)°,P＜0.05],解鏇率減低[(0.40 ±0.28) ％/ms比(0.46 ±0.14) ％/ms和(0.53±0.21)％/ms,P＜0.05],解鏇減半時間延遲[ (489.61 ±97.14)ms比(445.21±54.53) ms和(410.60±50.23) ms,P＜0.05].結論 斑點追蹤成像技術能夠準確評價2型糖尿病心髒自主神經病變患者左心室功能及扭轉運動的異常.
목적 응용반점추종성상기술연구당뇨병심장자주신경병변환자좌심실공능급뉴전운동,탐토기림상응용개치.방법 2형당뇨병불반병발증환자35례(A조),2형당뇨병반심장자주신경병변자21례(B조),정상대조자34례(대조조).측량화계산좌심실18절단원주수축기응변봉치、서장조기(E′)급서장만기(A′)응변봉치、각수평화정체수축기원주응변봉치、E′/A′、수축말기뉴전각도、등용서장말기뉴전각도、해선솔화해선감반시간.결과 여대조조상비A조환자좌심실수축기각수평급정체원주응변차이무통계학의의(P＞0.05),단E′/A′강저(P＜0.05)、수축말기뉴전각도화등용서장말기뉴전각도증가(P＜0.05),해선솔감저(P＜0.05),해선감반시간연지(P＜0.05),B조환자좌심실수축기각수평급정체원주응변교A조급대조조감약[(-12.64±6.49)％비(-19.11 ±9.98)％화(-21.14±10.13)％,P＜0.05]、E′/A′강저[(0.90 ±0.35)비(1.24 ±0.47)화( 1.98±0.63),P＜0.05]、수축말기뉴전각도화등용서장말기뉴전각도증가[(19.08 ±5.62)°비(16.57±2.84)°화(14.36±4.06)°,(13.99 ±2.31)°비(11.36 ±2.63)°화(9.04±5.63)°,P＜0.05],해선솔감저[(0.40 ±0.28) ％/ms비(0.46 ±0.14) ％/ms화(0.53±0.21)％/ms,P＜0.05],해선감반시간연지[ (489.61 ±97.14)ms비(445.21±54.53) ms화(410.60±50.23) ms,P＜0.05].결론 반점추종성상기술능구준학평개2형당뇨병심장자주신경병변환자좌심실공능급뉴전운동적이상.
Objective To evaluate left ventricular (LV) function and twist in patients with diabetic cardiovascular autonomic neuropathy (CAN) by two-dimensional speckle tracking imaging (STI).Methods STI was performed in 56 subjects with type 2 diabetes mellitus (DM) (35 with DM only:group A,21 with CAN:group B) and 34 normal subjects (Control) from LV short-axis view.LV peak systolic,peak early (E′) and peak late (A′) diastolic circumferential strain in 18 myocardial segments were measured at the levels of mitral annulus,papillary muscle and apex and the rotation at mitral annulus and apex levels were also measured.LV peak systolic and the ratio of E′ and A′ of global and three levels,twist,untwisting rate and untwisting half-time were calculated.Results In group A,compared with control group,LV peak systolic radial circumferential strain has no significant difference ( P ＞ 0.05 ),E'/A' was reduced ( P ＜0.05),twist at aortic valve closure and twist at mitral valve opening were significantly increased ( P ＜0.05),untwisting rate reduced,and untwisting half time delayed.In group B,compared with control group and group A,circumferential strain parameters [( - 12.64 ± 6.49)％ vs.( - 19.11 ± 9.98)％ and (-21.14±10.13)％,P＜0.05] andE′/A′ [(0.90 ±0.35) vs.(1.24 ±0.47) and (1.98 ±0.63),P ＜ 0.05 ] were significantly decreased,twist at aortic valve closure [ ( 19.08 ± 5.62) ° vs.( 16.57 ± 2.84) °and ( 14.36 ±4.06) °,P ＜0.05] and twist at mitral valve opening [ ( 13.99 ± 2.31 ) ° vs.( 11.36 ± 2.63 ) °and (9.04 ± 5.63 ) °,P ＜ 0.05 ] were significantly increased,untwisting rate [ ( 0.40 ± 0.28 ) ％/ms vs.(0.46 ±0.14)％/ms and (0.53 ±0.21 )％/ms,P ＜0.05 ] reduced,and untwisting half time[ (489.61 ±97.14)ms vs.(445.21 ±54.53)ms and(410.60 ±50.23)ms,P ＜0.05] delayed.Conclusion Speckle tracking imaging could be used to evaluate early changes on LV twist deformation and LV systolic function in patients with type 2 diabetes mellitus.
