摘要
目的:探讨二维斑点追踪超声心动图(2D-STE)评估2型糖尿病患者右心功能的临床价值。方法:搜集我院收治的糖尿病患者127例,并根据代谢风险因素进行分层,其中低风险组(DM1)60例,高风险组(DM2)67例;同时选取同期年龄、性别与之相匹配的健康志愿者41例为对照组。搜集所有受试者血压、甘油三酯、BMI等临床资料;进行常规超声心动图和2D-STE检查,离线分析右心室游离壁应变,并进一步对右心室游离壁进行分段分析。比较糖尿病组与正常对照组、DM1组与DM2组各参数的差异,并应用受试者工作特征(ROC)曲线分析相关参数评估右心功能的价值。结果:糖尿病组的右心室游离壁厚度、三尖瓣环收缩期速度、右心室心肌工作指数较正常对照组显著增高,三尖瓣E/A值、右心室游离壁应变RVFWS绝对值、右心室游离壁基底段、中间段及心尖段应变绝对值较对照组明显下降,差异有统计学差异(P<0.05)。DM2组的右心室游离壁厚度及右心室心肌工作指数较DM1组增高,右心室游离壁应变绝对值、右心室游离壁中间段及心尖段应变绝对值较DM1组显著下降,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,心尖段应变区分DM1组与DM2组的效能较高,约登指数为0.389,AUC为0.743(95%CI:0.657~0.829),敏感度为0.806,特异度为0.583。结论:二维斑点追踪成像有助于及时发现糖尿病患者右心室功能变化,且合并高代谢风险因素糖尿病患者的右心室功能变化更明显。
Objective:To investigate the clinical value of two-dimensional speckle tracking echocardiography(2D-STE)in evaluating the right ventricular function in type 2 diabetes patients with metabolic risk stratification.Methods:127 patients with diabetes in our hospital were gathered and stratified to 60 cases in the low-risk group(DM1)and 67 cases in the high-risk group(DM2)according to metabolic risk factors.At the same time,40 healthy volunteers of the same age and gender were selected as the control group.All subjects'entrance and clinical data on hypertension,triglycerides,and BMI,were collected.We performed routine echocardiography and a 2D-STE examination,analyzed the strain of the right ventricular free wall offline,and further performed a segmented analysis of the right ventricular free wall.The differences in parameters between the diabetes group and the normal control group,DM1 group,and DM2 group were compared.Results:The right ventricular free wall thickness,tricuspid ring systolic velocity,and right ventricular myocardial working index in the diabetes group were significantly increased compared with the control group,while the E/A value of the tricuspid valve,the absolute value of right ventricular free wall strain RVFWS,the absolute value of the right ventricular free wall strain in the base segment,middle segment,and apex segment were significantly decreased compared with the control group,with statistical difference(P<0.05).The right ventricular free wall thickness and right ventricular myocardial working index in DM2 group were higher than those in DM1 group.The absolute values of the right ventricular free wall strain,middle and apex strains of the right ventricular free wall in DM2 group were significantly lower than those in DM1 group,with statistical significance(P<0.05).ROC curve analysis showed that the efficiency of apical segment strain differentiation between DM1 and DM2 group was higher,with the Yoden index 0.389,the AUC 0.743(95%CI:0.657~0.829),the sensitivity 0.806,and the specificity 0.583.Conclusion:Two-dimensional spot tracking imaging parameters can timely detect the impairment of right ventricular function in diabetic patients.The impairment of right ventricular function in diabetic patients with high metabolic risk factors is more serious.
作者
夏莉莉
胡献金
童陶然
董崇周
谢莉萍
郑慧
XIA Li-li;HU Xian-jin;TONG Tao-ran(Department of Ultrasound,First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)
出处
《放射学实践》
CSCD
北大核心
2024年第9期1238-1243,共6页
Radiologic Practice
基金
蚌埠医学院科研课题(2023byzd044)。
关键词
2型糖尿病
心脏功能
右心室
超声检查
二维斑点追踪成像
Type 2 diabetes mellitus
Heart function
Right ventricle
Ultrasonography
Two-dimensional spot tracking imaging
