二维斑点追踪成像评估2型糖尿病患者右心室功能

㊃临床研究㊃

DOI :10.3760/cma.j .

issn.1004-4477.2015.08.005基金项目:宁波市社会发展科研项目(2013C 50046,2011C 50023);浙江省医学会临床科研资金项目(2013ZYC -A 69)作者单位:315010 宁波市第一医院超声科(

俞霏㊁许幼峰㊁毛锋㊁姜月茗茗㊁陈立斌㊁张盛敏㊁尹凤英),内分泌科(胡芳芳)

通信作者:许幼峰,Email :2371334413@qq .com

二维斑点追踪成像评估2型糖尿病患者右心室功能

俞霏 许幼峰 毛锋 姜月茗茗 陈立斌 胡芳芳 张盛敏 尹凤英

ʌ摘要ɔ 目的 应用二维斑点追踪成像(2D -STI )

评估2型糖尿病患者的右心室收缩功能㊂方法 连续选取50例2型糖尿病患者及50例年龄匹配的正常对照者行超声心动图检查,测量:①右心腔大小㊁右室壁厚度;②右心室面积变化率(RVFAC )㊁三尖瓣环侧壁收缩期组织速度(S '

)㊁三尖瓣环平面收缩期位移(TAPSE )㊁四腔心切面右心室壁6个节段纵向应变;③三尖瓣口舒张期血流E ㊁A 峰比值(E /A )㊁E 峰与组

织多普勒三尖瓣环舒张速度E '峰比值(E /E ')㊁右心室Tei 指数等㊂统计分析组间测值差异㊂结果 与对照组相比,糖尿病组右心腔大小差异无统计学意义(P >0.05),而右室壁厚度增加(P =0.000);右室侧壁中间段㊁室间隔中间段与基底段的二维应变绝对值降低(P =0.001㊁0.000及0.005),而另3个节段应变值以及RVFAC ㊁TAPSE ㊁S '差异无统计学意义(P >0.05);E /E '增高㊁E /A 降低㊁右心室Tei 指数增高(P =

0.000㊁0.000及0.006)㊂结论 2D -STI 较常规参数更敏感,能在早期反映2型糖尿病患者的右心室收缩功能改变;而右心室6个节段中,侧壁中间段㊁室间隔中间段及室间隔基底段的应变测值更可靠㊂

ʌ关键词ɔ 超声心动描记术;

糖尿病;心室功能,右;应变Echocardio g ra p hic evaluation of ri g ht ventricular function in t yp e -2diabetic p atients usin g 2-dimensional s p eckle trackin g ima g in g Yu Fei ,Xu You f en g ,Mao Fen g ,J ian g Yuemin g min g ,Chen Libin ,Hu

Fan gf an g ,Zhan g Shen g min ,Yin Fen g y in g .De p artment o f Ultrasono g ra p h y ,Nin g bo First Hos p ital ,Nin g bo 315010,China Coores p ondin g author :Xu You f en g ,Email :2371334413@qq .com

ʌAbstract ɔ Ob j ective To evaluate ri g ht ventricular (RV )s y stolic function in t yp e -2diabetes mellitus (T 2DM )p atients.Methods Fift y T 2DM p atients and fift y normal controls were included in the stud y and underwent echocardio g ra p hic examinations.The followin g p arameters were measured :1)Ri g ht heart

dimensions ,p ulmonar y arter y (PA )diameter ,p ulmonar y acceleration time (AT )and PA s y stolic p ressure (PASP );2)RV s y stolic function :RV fractional area chan g e (RVFAC ),tissue Do pp ler -derived tricus p id

lateral annular s y stolic velocit y (S '),tricus p id annular p lane s y stolic excursion (TAPSE ),lon g itudinal strain

of six RV se g ments b y 2-dimensional s p eckle trackin g ima g in g (2D -STI );3)RV diastolic function :E ,A

ratio of the tricus p id inflow s p ectrum (E /A ),E ,E '(p eak earl y diastolic velocit y of the tricus p id annulus )

ratio (E /E ');4)RV Tei index.Results Statistic anal y sis showed that T 2DM p atients had thicker RV walls ,wider PAs and shorter AT than the control g rou p (P =0.

000,0.001and 0.000),while their ri g ht heart chamber sizes and PASP remained unchan g ed.Amon g s y stolic p arameters ,absolute values of RV lon g itudinal strain at the lateral wall -mid (lat -m ),se p tum -mid (se p -m )and se p tum -basal (se p -b )se g ments

were si g nificantl y lower in the diabetic g rou p than the control g rou p (P =0.

001,0.000and 0.005),whereas strain of the other three RV se g ments and RVFAC ,TAPSE.S 'were not si g nificantl y different.Moreover ,E /A ,E /E 'and Tei index were all si g nificantl y different between the two g rou p s (P =0.

000,0.000and 0.006),indicatin g declined diastolic and g eneral function of RV in the T 2DM g rou p .Conclusions RV

m y ocardial strain b y 2D -STI is more sensitive in detectin g RV s y stolic d y sfunction than TAPSE ,S 'and RVFAC.Amon g the six se g ments of RV walls ,lat -m ,se p -m and se p -b are better locations for 2D -STI than

the other three.

ʌKe y words ɔ Echocardio g ra p h y ;Diabetes mellitus ;Ventricular function ,ri g ht ;Strain