摘要目的 应用二维斑点追踪成像(2D-STI)技术评价2型糖尿病(DM)患者右室心肌功能的变化特点.方法 37例单纯DM、31例2-DM合并高血压(DM+ HTN)患者和39例对照者接受常规二维超声检查及心肌应变和应变率检查.在二维右室心尖四腔观动态图像上应用2D-STI测量右室游离壁、室间隔壁及右室整体心肌的收缩期纵向峰值应变(F-PLSS、S-PLSS、G-PLSS)；记录收缩期、舒张早期及舒张晚期右室整体纵向峰值应变率(G-SRs、G-SRe、G-SRa).结果 ①DM组和DM+ HTN组F-PLSS、S-PLSS和G-PLSS均较对照组降低(均P＜0.01),其中DM+ HTN较DM组患者下降更显著,两组上述各参数之间的差异也具有统计学意义(P＜0.05).②G-SRs和G-SRe在三组之间的差异均有统计学意义(均P＜0.01).③与对照组相比DM+ HTN组G-SRa下降显著(P＜0.05),而DM组和对照组与DM+HTN组之间G-SRa的差异无统计学意义(P＞0.05).结论 DM患者无论是否合并高血压,2D-STI均可以早期发现右室功能减低；当DM患者合并高血压时,右室功能减低更加明显.

abstractsObjective To assess the right ventricular (RV) performance in patients with type 2 diabetes mellitus (2-DM) by two-dimensional speckle tracking imaging (2D-STI),and to explore the clinical value of RV longitudinal strain and strain rate.Methods Thirty-seven patients with 2-DM only and thirtyone patients coexisting diabetes and hypertension (DM + HTN) were studied.Thirty-nine healthy age matched persons served as control subjects.In each patient a conventional two-dimensional echocardiography was performed and also an echocardiographic study with strain/strain rate imaging was studied.Analysis of RV longitudinal systolic strain were obtained in the apical four-chamber view of the RV for the assessment of the RV free wall(F-PLSS),interventricular septum (S-PLSS) and the global RV wall (G-PLSS).The entire RV longitudinal peak systolic strain rate (G-SRs),peak early-diastolic strain rate (G-SRe) and peak late-diastolic strain rate (G-SRa) were performed in the apical four-chamber view.Results Compared with controls,F-PLSS,S-PLSS,G-PLSS,G-SRs and G-SRe were decreased in 2-DM and DM + HTN (all P ＜0.01),with lower values in DM + HTN (P ＜0.05).In the patients coexisting diabetes and hypertension,G-SRa was significantly lower than those in the control group (P ＜ 0.05).Compared with 2-DM,this difference was not significant in controls and DM + HTN (P ＞0.05).Conclusions No matte the patients of 2-DM with or without hypertension,the early changes of RV dysfunction can be found by 2D-STI.Patients coexisting diabetes and hypertension may have worse RV dysfunction.