| 摘要: |
| 目的: 探讨实时三维超声心动图（RT-3DE）评价2型糖尿病(DM)患者左房(LA)容积和功能的价值。
方法: 选择糖单纯糖尿病患者（DM1）52例，糖尿病合并微循环病变者（DM2）56例，健康对照组58例，使用二维超声检测心脏的一般结构及功能，应用RT-3DE检测左房最大容积（LAVmax）、左房收缩前容积（LAVp）及左房最小容积（LAVmin），计算并比较三组间左房容积及功能参数，并分析左房最大容积指数（LAVImax）与氨基端-脑钠肽前体(NT-proBNP)、糖化血红蛋白（GHbA1）及E/e的相关性。
结果：
（1）DM2组左房内径较DM1组及对照组均增大（P<0.05）；DM1组较对照组差异无统计学意义；DM1组和2组等容舒张时间（IVRT）及E/e均较对照组增加（P<0.05）；DM2组IVRT较DM1组延长（P<0.05）。
(2)DM2组LA容积（LAVmax、LAVmin、LAVp、LAVImax、LAVImin、LAVIp）、储存功能（LAEFt）及泵功能（LAEFa）指标均较对照组明显升高（P<0.05）；DM1组只有LAVmax、LAVp、LAVImax、LAVIp及LAEFa增大（P<0.05）；两组反映LA管道功能的LAEFp均减小（P<0.05）；与DM1组比较，DM2组LAVImax、LAVIp、LAEFt、LAEFa均明显增加（P<0.05）。
(3)LAVImax与E/e呈强相关，与NT-proBNP呈正相关，而与GHbA1呈弱相关。
结论： 糖尿病患者左房容积和机械功能受损，且合并微循环病变者损害更加显著，RT-3DE有望成为一种新的评估糖尿病患者左房容积和功能的新方法。 |
| 关键词: 2型糖尿病 左房容积和功能 实时三维超声心动图 |
| DOI： |
| 投稿时间：2017-03-01修订日期：2017-04-09 |
| 基金项目: |
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| Assessment of left atrial volume and function by real time three-dimensional echocardiography in diabetes patients |
| huohuauhuan |
| () |
| Abstract: |
| Objective:To evaluate left atrial volume and function in diabetes patients using real time three-dimension echocardiography.
Methods：This study included 108 diabetes（56 with micro-circulative pathological changes ）and 58 normal controls with similar age and sex.All the participants underwent RT-3DE to assess LA volume and mechanical function.Plasma NT-proBNP and GHbA1 are tested.
Results:
（1）The left atrial diameter was much higher in DM2 group compared with controls and DM1 group（P<0.05）,while there was no significant difference between DM1 and control group；The E/e and IVRT were increase in both DM groups （P<0.05）， IVRT was higher in DM2 group compared with DM1 group（P<0.05）.
（2）The LAVmax、LAVmin、LAVp、LAVImax、LAVImin、LAEFt and LAEFa were all found to be significantly higher in DM2 group when compared with controls,which reflect LA volume 、reservoir and pump functions, and that only LAVmax、LAVp、LAVImax、LAVIp and LAEFa were increased in DM1 group.Further more, LAVImax、LAVIp、LAEFt and LAEFa in DM2 group are higher when compared with DM1 group（P<0.05）.
（3）There were strong relationship between LAVI and E/e,and positive with NT-proBNP,only weak with GHbA1.
Conlusions:LA mechanical functions and volumes are already impaired in diabetes patients，and it is more obvious in patients with micro-circulative pathological change.RT-3DE may be a useful way for assessment of left atrial function in diabetes patients. |
| Key words: Diabetes LA function and volume Real-time three-dimension echocardiography |
