刘佳慧,马淑梅

2型糖尿病（T2DM）是全球范围内的重大公共卫生问题，其心血管并发症是患者死亡的主要原因，左心室功能异常是T2DM患者常见且隐匿的心血管病变[1]。超声心动图作为无创、实时的影像学技术，在T2DM患者左心室功能评估中具有不可替代的作用[2]。本文阐述了T2DM导致左心室功能异常的发病机制（包括胰岛素抵抗、高血糖、微血管病变等），并对传统超声（M型、二维、多普勒）、组织多普勒成像（TDI）、斑点追踪成像（STI）等技术在左心室收缩及舒张功能评估中的应用进展进行综述。

2型糖尿病患者；超声心动图；左心室功能

[1] Buehring B,Siglinsky E,Krueger D,et al.Comparison of muscle/lean mass measurement methods:correlation with functional and biochemical testing[J].Osteoporosis International,2018,29(3):675-683. [2] Yuan M,Jiang L,Sun C,et al.Diagnostic and prognostic value of parameters of erector spinae in patients with uremic sarcopenia[J]. Clinical Radiology,2024,79(7):e900-e907. [3] Sun Y,Wang W,Mi C,等.Differential Diagnosis Value of Shear-Wave Elastography for Superficial Enlarged Lymph Nodes[J].Frontiers in Oncology,2022,12:908085. [4] Gatz M,Betsch M,Dirrichs T,et al.Eccentric and Isometric Exercises in Achilles Tendinopathy Evaluated by the VISA-A Score and Shear Wave Elastography[J].Sports Health:A Multidisciplinary Approach,2020,12(4):373-381. [5] Liu S,Han X,Li J,等.Feasibility of using chest computed tomography(CT)imaging at the first lumbar vertebra(L1)level to assess skeletal muscle mass:a retrospective study[J].PeerJ,2023,11:e16652. [6] Ivanoski S,Vasilevska Nikodinovska V.Future Ultrasound Biomarkers for Sarcopenia:Elastography,Contrast-Enhanced Ultrasound,and Speed of Sound Ultrasound Imaging[J].Seminars in Musculoskeletal Radiology,2020,24(02):194-200. [7] Ciuffreda G,Estébanez-de-Miguel E,Albarova-Corral I,et al.Impact of Neurodynamic Sequencing on the Mechanical Behaviour of the Median Nerve and Brachial Plexus:An Ultrasound Shear Wave Elastography Study[J].Diagnostics,2024,14(24):2881. [8] Mauriello A,Correra A,Ascrizzi A,et al.Relationship Between Left Atrial Strain and Atrial Fibrillation:The Role of Stress Echocardiography[J].Diagnostics,2024,15(1):7. [9] Chianca V,Albano D,Messina C,等.Sarcopenia:imaging assessment and clinical application[J].Abdominal Radiology(New York),2022, 47(9):3205-3216. [10] Maiolo C,Cervelli V,Fede M C,et al.Soft Tissue Composition in Upper Leg Lipodystrophy:Application of Dual Energy X-Ray Absorptiometry[J].Aesthetic Plastic Surgery,2002,26(5):345-347. [11] Staempfli J S,Kistler-Fischbacher M,Gewiess J,et al.The Validity of Muscle Ultrasound in the Diagnostic Workup of Sarcopenia Among Older Adults:A Scoping Review[J].Clinical Interventions in Aging. [12] Wei W,Xie C,Cao R,et al.Ultrasound Assessment of the Gastrocnemius Muscle as a Potential Tool for Identifying Sarcopenia in Patients with Type 2 Diabetes[J].Diabetes,Metabolic Syndrome and Obesity,2023,Volume 16:3435-3444. [13] Soldati G,Smargiassi A,Inchingolo R,等.Ultrasound-guided pleural puncture in supine or recumbent lateral position-feasibility study[J].Multidisciplinary Respiratory Medicine,2013,8(1):18. [14] Bastijns S,De Cock A M,Vandewoude M,et al.Usability and Pitfalls of Shear-Wave Elastography for Evaluation of Muscle Quality and Its Potential in Assessing Sarcopenia:A Review[J].Ultrasound in Medicine&Biology,2020,46(11):2891-2907. [15] Ličen U,KozincŽ.Using Shear-Wave Elastography to Assess Exercise-Induced Muscle Damage:A Review[J].Sensors,2022,22(19):7574. [16] Chen Z T,Jin F S,Guo L H,et al.Value of conventional ultrasound and shear wave elastography in the assessment of muscle mass and function in elderly people with type 2 diabetes[J].European Radiology,2023,33(6):4007-4015. [17] Messina C,Albano D,Gitto S,et al.Body composition with dual energy X-ray absorptiometry:from basics to new tools[J].Quantitative Imaging in Medicine and Surgery,2020,10(8):1687-1698. [18] Ciuffreda G,Bueno-Gracia E,Argüello-Espinosa M I,et al.Accuracy of the Standard and Distal-to-Proximal Sequence of the Upper Limb Neurodynamic Test 1 for the Diagnosis of Carpal Tunnel Syndrome:The Role of Side-to-Side Comparisons[J].Journal of Clinical Medicine,2024,13(23):7122. [19] Shahzad R,Fatima I,Anjum T,et al.Diagnostic value of strain elastography and shear wave elastography in differentiating benign and malignant breast lesions[J].Annals of Saudi Medicine,2022,42(5):319-326. [20] Zhang Z J,Ng G Y F,Fu S N.Effects of habitual loading on patellar tendon mechanical and morphological properties in basketball and volleyball players[J].European Journal of Applied Physiology,2015,115(11):2263-2269. [21] Kantarci F,Ustabasioglu F E,Delil S,et al.Median nerve stiffness measurement by shear wave elastography:a potential sonographic method in the diagnosis of carpal tunnel syndrome[J].European Radiology,2014,24(2):434-440.

点击下载PDF