超重、肥胖患者心脏结构、功能变化及影响因素研究

发布时间：2018-03-28 07:36

本文选题：体重指数　切入点：三维斑点追踪技术　出处：《生物医学工程学杂志》2016年01期

【摘要】：用超声心动图评价超重、肥胖患者心脏结构、功能变化,并探究心功能影响因素。本文将受试者分为正常组、超重组及肥胖组,各纳入34人,运用组织多普勒成像(TDI)、二维斑点追踪技术(2D-STI)及三维斑点追踪技术(3D-STI)分析比较三组心脏结构、功能变化。结果显示:与正常组比较,超重、肥胖组患者整体纵向峰值应变(GLS)、圆周峰值应变(GCS)、面积峰值应变(GAS)及径向峰值应变(GRS)递减,差异有统计学意义(P0.05);二尖瓣舒张早期前向血流速度与左室整体舒张早期峰值应变率之比(E/e′sr)(r=0.466,P0.001)以及GLS(r=0.502,P0.001)、GCS(r=0.426,P0.001)、GAS(r=0.535,P0.001)、GRS(r=-0.554,P0.001)等均与体重指数(BMI)相关;E/e′sr(r=0.37,P=0.003)、GLS(r=0.455,P0.001)、GCS(r=0.282,P=0.02)、GAS(r=0.412,P0.001)及GRS(r=-0.471,P0.001)均与游离脂肪酸(FFA)相关;stepwise逐步回归分析发现BMI与E/e′sr、GLS、GCS、GAS及GRS独立相关,腰臀比(WHR)与GLS、GCS、GAS及GRS独立相关,FFA与E/e′sr独立相关(P0.05)。研究表明超重、肥胖患者存在心脏结构改变及左室整体收缩、舒张功能受损,BMI、WHR、FFA可能是超重、肥胖患者心功能的独立影响因素。
[Abstract]:Echocardiography was used to evaluate the changes of cardiac structure and function in overweight and obese patients, and to explore the influencing factors of cardiac function. Tissue Doppler imaging (TDI), 2D speckle tracing (2D-STI) and 3D speckle tracing (3D-STI) were used to analyze and compare the changes of cardiac structure and function in the three groups. The whole longitudinal peak strain (GLSN), the circumferential peak strain (GCSA), the area peak strain (GASs) and the radial peak strain (GRS) decreased in obese group. The difference was statistically significant (P 0.05); the ratio of early mitral early diastolic flow velocity to left ventricular whole early diastolic peak strain rate (E / P = 0.466N / P 0.001) and GLS / R = 0.502N / P 0.001P 0.001GCSS / P 0.426P 0.001GASR / 0.535P ~ (0.535P ~ (0.554P _ 0.001)) were all correlated with the stepwise regression of free fatty acids (E / R ~ r ~ r ~ r ~ r ~ r ~ r ~ 0.37 ~ (0. 37) P _ 0.003G / S ~ (0.003) P ~ (0.003) P ~ (0.001)) and GCSS ~ (0.28) P ~ (0.4r1212) and Gr-0.474F _ (1) F _ (1) F _ (1)). It was found that BMI was independent of GRS and GCS gas. WHR / GCSGAS and GRS were independent correlated with E/e'sr (P0. 05). The study showed that there were cardiac structural changes and left ventricular global contraction in overweight and obese patients, and impaired diastolic function might be the independent influencing factors of heart function in overweight and obese patients.
【作者单位】：四川大学华西医院心内科;四川大学华西医院内分泌科;
【基金】：四川省卫生厅资助项目(JH2014085)
【分类号】：R540.45;R589.2

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