血糖控制对2型糖尿病患者左、右心室心肌功能的影响

doi:10.7517/issn.1674-0475.230807

影像科学与光化学 ›› 2024, Vol. 42 ›› Issue (1): 47-52.DOI: 10.7517/issn.1674-0475.230807

血糖控制对2型糖尿病患者左、右心室心肌功能的影响

梁丽媚¹, 何鑫¹, 赵世光¹, 张会欣¹, 刘红利²

1. 石家庄市第二医院超声医学科, 河北石家庄 050051;
2. 石家庄市第二医院内分泌科, 河北石家庄 050051

收稿日期:2023-08-18 修回日期:2023-12-11 发布日期:2024-02-21
通讯作者: 梁丽媚
基金资助:
河北省医学科学研究课题计划(20231628)

Impact of Glycemic Control on Left and Right Ventricular Myocardial Function in Type 2 Diabetic Patients

LIANG Limei¹, HE Xin¹, ZHAO Shiguang¹, ZHANG Huixin¹, LIU Hongli²

1. Department of Ultrasound, Second Hospital of Shijiazhuang City, Shijiazhuang 050051, Hebei, P.R. China;
2. Department of Endocrinology, Second Hospital of Shijiazhuang City, Shijiazhuang 050051, Hebei, P.R. China

Received:2023-08-18 Revised:2023-12-11 Published:2024-02-21

摘要/Abstract

摘要： 本研究探讨血糖控制对2型糖尿病(T2DM)患者左、右心室心肌应变的影响,以及左、右心室心肌功能障碍之间的关系。选取100例左心室射血分数正常的T2DM患者,根据糖化血红蛋白(HbA1c)水平分为HbA1c＜7%组(n=54)和HbA1c≥7%组(n=46);同时选取40名健康成人志愿者作为对照组。测量常规超声心动图及左心室整体纵向应变(LVGLS)、右心室整体纵向应变(RVGLS)、右心室游离壁纵向应变(RVFWLS)数据。比较各组数据的差异,应用多元线性回归分析HbA1c对左、右心室心肌应变的影响,以及左、右心室心肌应变之间的关系。从对照组、HbA1c＜7%组到HbA1c≥7%组,LVGLS、RVGLS逐渐减低(均P＜0.05)。与对照组比较,HbA1c＜7%组、HbA1c≥7%组的RVFWLS均减低(均P＜0.05),但后两组的RVFWLS差异无统计学意义(P＞0.05)。多元线性回归分析显示,在T2DM患者中,HbA1c是LVGLS、RVGLS、RVFWLS的独立影响因素,LVGLS与RVGLS、RVFWLS独立相关。左心室射血分数正常的T2DM患者左、右心室心肌应变均减低,且两者间存在相关性,HbA1c是左、右心室心肌应变减低的独立影响因素,提示高血糖可能同时对双心室的心肌产生直接作用,且心室间存在不利的相互作用。

关键词: 2型糖尿病, 血糖控制, 左心室, 右心室

Abstract: This study investigated on left and right ventricular myocardial strain in patients with type 2 diabetes mellitus (T2DM), and the relationship between left and right ventricular dysfunction. A total of 100 patients with T2DM and normal left ventricular ejection fraction (LVEF) were divided into HbA1c＜7% group (n=54) and HbA1c≥7% group (n=46) according to HbA1c level. Forty healthy adult volunteers were selected as the control group. The data of conventional echocardiography and left ventricular global longitudinal strain (LVGLS), right ventricular global longitudinal strain (RVGLS) and right ventricular free wall longitudinal strain (RVFWLS) data were measured. The differences were compared among the groups. Multivariable linear regression analysis was performed for the associated between HbA1c and biventricular myocardial strain, and the correlation 47between left and right ventricular myocardial strain. LVGLS and RVGLS decreased gradually from the control group, HbA1c＜7% group to HbA1c≥7% group (all P<0.05). Compared with the control group, RVFWLS was decreased in HbA1c＜7% group and HbA1c≥7% group (all P＜0.05). However, there was no significant difference between the latter two (P＞0.05). Multiple linear regression analysis showed that HbA1c was the independent determinants for LVGLS, RVGLS and RVFWLS in T2DM patients, and LVGLS was independently associated with RVGLS and RVFWLS. The left and right ventricular myocardial strain decreased, and there is association between them in T2DM patients with normal left ventricular ejection fraction. HbA1c is an independent determinant for left and right ventricular myocardial dysfunction, suggesting that hyperglycemia was independently associated with impaired of the biventricular myocardial at the same time, and suggests adverse interventricular interactions.

Key words: type 2 diabetes mellitus, glycemic control, left ventricle, right ventricle

梁丽媚, 何鑫, 赵世光, 张会欣, 刘红利. 血糖控制对2型糖尿病患者左、右心室心肌功能的影响[J]. 影像科学与光化学, 2024, 42(1): 47-52.

LIANG Limei, HE Xin, ZHAO Shiguang, ZHANG Huixin, LIU Hongli. Impact of Glycemic Control on Left and Right Ventricular Myocardial Function in Type 2 Diabetic Patients[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2024, 42(1): 47-52.

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血糖控制对2型糖尿病患者左、右心室心肌功能的影响

Impact of Glycemic Control on Left and Right Ventricular Myocardial Function in Type 2 Diabetic Patients

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