三维斑点追踪技术评价非酒精性脂肪肝对2型糖尿病患者左心室功能的影响

摘要

目的 利用超声三维斑点追踪技术评价2型糖尿病合并与不合并非酒精性脂肪肝患者的左心室整体功能.方法 80例2型糖尿病患者分为单纯糖尿病组(40例)和糖尿病合并非酒精性脂肪肝组(40例).选择40例年龄、性别匹配的健康体检者作为对照组.采集左心室全容积图像分析,计算射血分数(EF)、整体纵向应变(GLS)、圆周应变(GCS)、面积应变(GAS)和径向应变(GRS).结果 单纯糖尿病组GLS、GCS和GRS显著低于对照组(all P＜0.05),而糖尿病合并非酒精性脂肪肝组GLS、GCS、GAS和GRS均显著低于对照组,且GLS、GAS和GRS显著低于单纯糖尿病组(all P＜0.001).糖尿病合并中、重度脂肪肝患者多方向的左室应变显著低于合并轻度脂肪肝患者(all P＜0.05).结论 超声三维斑点追踪技术可以检测出2型糖尿病合并与不合并非酒精性脂肪肝患者的左心室亚临床功能障碍.%Objective To evaluate the LV function in type 2 diabetic patients with or without non alcoholic fatty liver disease (NAFLD) using three-dimensional speckle-tracking echocardiography (3DSTE).Methods Eighty T2DM patients,including 40 subjects with T2DM alone and 40 subjects with T2DM and NAFLD,and 40 age-and sexmatched controls were studied.The LV full-volume images were recorded and analyzed.The ejection fraction (EF),global longitudinal strain (GLS),global circumferential strain (GCS),global area strain (GAS) and global radial strain (GRS) were calculated.Results The patients with T2DM alone had significantly lower GLS,GCS and GRS when compared with the controls (all P＜0.05),while the patients with T2DM and NAFLD showed significantly lower GLS,GCS,GAS,and GRS when compared with the controls,and also showed significantly lower GLS,GAS and GRS when compared with the patients with T2DM alone (all P＜0.001).The strain values in multiple directions decreased significantly in the T2DM patients with moderate and severe NAFLD than in those with mild NAFLD(all P＜0.05).Conclusions Three-dimensional speckle-tracking echocardiography(3DSTE) could detect the subclinical LV dysfunction in T2DM pationts with or without NAFLD.