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目的探讨二维斑点追踪技术在评估糖尿病前期患者左心室亚临床心肌损伤中的价值。方法糖尿病前期患者46例为观察组,同期45例体检健康者为对照组,均行超声心动图检查,测量左心室舒张末期容积(left ventricular end-diastolic volume,LVEDV)、左心室收缩末期容积(left ventricular end-systolic volume,LVESV)、左室射血分数(left ventricular ejection fraction,LVEF)、室间隔舒张末期厚度(interventricular septal end-diastolic thickness,IVST)、左心室后壁舒张末期厚度(left ventricular posterior wall end-diastolic thickness,LVPWT)、左心房内径(left atrial inner diameter,LAID)、跨二尖瓣舒张早期血流速度(E峰)和舒张早期二尖瓣环运动速度(E峰);然后切换至二维斑点追踪技术模式,获取左心室二维16节段的应变-时间曲线和牛眼图,读取左心室二维整体纵向应变(global longitudinal strain,GLS)、二维整体圆周应变(global circumferential strain,GCS)以及二维整体径向应变(global radial strain,GRS),并进行比较。结果观察组LVEDV[(82.8±7.1)mL]、LVESV[(30.6±3.9)mL]、LVEF[(62.6±4.2)%]、IVST[(7.7±1.2)mm]、LVPWT[(7.3±1.1)mm]与对照组[(80.3±6.1)mL]、LVESV[(29.3±3.7)mL]、LVEF[(63.3±4.1)%]、IVST[(7.6±1.2)mm]、LVPWT[(7.1±1.1)mm]比较差异无统计学意义(P>0.05),LAID[(33.7±3.9)mm]和E/E(8.7±1.6)高于对照组[(31.4±2.6)mm和(7.7±0.9)](P<0.05);观察组|GLS|(17.7±2.6)低于对照组(21.3±4.7)(P<0.05),|GCS|(23.5±3.2)、GRS(32.7±3.9)与对照组(24.5±3.8、33.7±3.6)比较差异无统计学意义(P>0.05)。结论糖尿病前期患者左心室已出现亚临床心肌损伤,GLS是糖尿病前期患者左心室亚临床心肌损伤的敏感指标。
Objective To investigate the value of two-dimensional speckle tracking in assessing left ventricular subclinical myocardial injury in pre-diabetic patients. Methods Forty-six patients with pre-diabetes were enrolled as observation group and 45 healthy controls as control group. Echocardiography was performed to measure left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), interventricular septal end-diastolic thickness (IVST), left ventricular posterior wall thickness posterior wall end diastolic thickness (LVPWT), left atrial inner diameter (LAID), mitral early diastolic flow velocity (E peak) and early diastolic mitral annulus velocity (E 峰 peak). And then switched to the two-dimensional speckle tracking technology model to obtain the two-dimensional left ventricular 16-segment strain-time curve and the bull’s eye diagram to read the left ventricular two-dimensional global longitudinal strain (GLS), two-dimensional global circumferential strain global circumferential strain (GCS) and two-dimensional global radial strain (GRS) were compared and compared. Results LVEDV [(82.8 ± 7.1) mL], LVESV [(30.6 ± 3.9) mL], LVEF [(62.6 ± 4.2)%], IVST (7.7 ± 1.2) mm and LVPWT [(7.3 ± 1.1) mm], LVESV [(29.3 ± 3.7) mL], LVEF [(63.3 ± 4.1)%], IVST [(7.6 ± 1.2) mm], LVPWT [(7.1 ± 1.1) ) were significantly higher than those in the control group [(31.4 ± 2.6) mm and (7.7 ± 0.9) mm], respectively (P> 0.05) ) (P <0.05). The GLS | of the observation group was significantly lower than that of the control group (21.7 ± 4.7) (P <0.05), the GCS (23.5 ± 3.2) and the GRS (32.7 ± 3.9) There was no significant difference between the two groups (24.5 ± 3.8, 33.7 ± 3.6) (P> 0.05). Conclusions The subclinical myocardial injury has been found in the left ventricle in pre-diabetic patients. GLS is a sensitive indicator of subclinical myocardial injury in patients with pre-diabetes.