| 摘要: |
| 目的：应用斑点追踪分层应变技术评价急性冠脉综合征合并糖尿病患者左室心肌分层应变特点，并分析TyG指数与分层应变参数之间的相关性。资料与方法：严格按照纳入标准选取自2020年10月—2021年12月在兰州大学第一医院心内科入院诊断考虑为急性冠脉综合征并行冠脉造影的76例患者，根据患者是否合并糖尿病分为：单纯急性冠脉综合征组（n=38，c=38.8%）、急性冠脉综合征合并糖尿病组（n=38，c=38.8%）并选取同期健康体检患者22例为对照组（n=22，c=22.4%）。依据患者血检验结果计算TyG指数，应用二维斑点追踪分层应变技术分别测量左室心内膜下、中层、心外膜下心肌整体纵向应变，采用pearson相关性分析、岭回归分析方法分析TyG指数与斑点追踪分层应变参数之间的关系，根据分析结果建立模型。结果：（1）与单纯急性冠脉综合征组和对照组相比，急性冠脉综合征合并糖尿病组TyG指数明显升高（P<0.05）；（2）急性冠脉综合征合并糖尿病组的射血分数以及心肌各层应变明显减低，心肌各层纵向应变从心内膜至心外膜层呈梯度递减，其中，心内膜下纵向应变在急性冠脉综合征合并糖尿病组与单纯急性冠脉综合征组间存在显著差异（P<0.05）；（3）TyG指数与射血分数呈负相关，与左室心肌各层纵向应变均呈正相关（P<0.05）。结论：斑点追踪分层应变技术可以定量评估急性冠脉综合征合并糖尿病患者的心室重塑，并且TyG指数作为一种简便易得的胰岛素抵抗标志物，与其呈一定的相关关系。 |
| 关键词: 急性冠脉综合征 糖尿病 甘油三酯葡萄糖指数 分层应变 |
| DOI： |
| 投稿时间：2022-08-22修订日期：2022-10-14 |
| 基金项目:甘肃省自然科学基金 |
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| Correlation analysis of layer-specific speckle tracking technique and triglyceride-glucose index in patients with acute coronary syndrome and diabetes mellitus |
| liu jiajia,zhang lu,yang mengqi,zhang yan,deng aiyun |
| () |
| Abstract: |
| To analyze the relationship between triglyceride-glucose (TyG) index and left ventricular systolic function and myocardial layer-specific strain in patients with the acute coronary syndrome (ACS) complicated with diabetes mellitus (DM). Methods Seventy-six patients suspected of being diagnosed with the acute coronary syndrome who underwent coronary angiography were enrolled from the Department of Cardiology in the First Hospital of Lanzhou University between October 2020 and December 2021. According to whether the patients were complicated with diabetes, they were divided into a simple acute coronary syndrome group, an acute coronary syndrome complicated with diabetes group, and twenty-two healthy patients during the same period were selected as the control group. The TyG index was calculated based on blood test results, and a two-dimensional layer-specific speckle tracking technique was used to measure the left ventricular global longitudinal strain in the endocardial layer (GLSendo), mid-myocardial layer (GLSmid) and epicardial layer (GLSepi), Pearson correlation analysis and ridge regression analysis were used to analyze the relationship between TyG index and speckle tracking layered strain parameters, and a model was established according to the analysis results. Results Compared with the ACS alone and control groups, the TyG index was significantly increased in ACS combined with the DM group (P < 0.05). The left ventricular ejection fraction and the strain of each layer of the myocardium were significantly reduced in the ACS combined DM group, in which the global longitudinal strain value from the endocardium to the epicardium decreased gradually. Among them, GLSendo had significant differences between the ACS combined DM group and the ACS alone group (P < 0.05). The TyG index was negatively correlated with left ventricular ejection fraction and positively correlated with GLSendo, GLSmid, and GLSepi (P < 0.05). Conclusion Speckle tracking layer-specific strain technique can quantitatively assess ventricular remodelling in patients with acute coronary syndrome and diabetes, and the TyG index, as a readily available marker of insulin resistance, is correlated with it. |
| Key words: acute coronary syndrome, diabetes mellitus, triglyceride-glucose index, layer-specific strain |
