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(P<0.05);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,P<0.001)以及GLS(r=0.502,P<0.001)、GCS(r=0.426,P<0.001)、GAS(r=0.535,P<0.001)、GRS(r=-0.554,P<0.001)等均与体重指数(BMI)相关;E/e′sr(r=0.37,P=0.003)、GLS(r=0.455,P<0.001)、GCS(r=0.282,P=0.02)、GAS(r=0.412,P<0.001)及GRS(r=-0.471,P<0.001)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(P<0.05)。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。 Echocardiography was used to evaluate the changes of heart structure and function in overweight and obese patients and explore the influencing factors of cardiac function. In this study, subjects were divided into normal group, overweight group and obesity group, 34 patients were enrolled in this study. Tissue Doppler imaging (TDI), 2D-STI and 3D speckle tracking ) Analysis and comparison of three groups of cardiac structure, functional changes. The results showed that compared with the normal group, the global longitudinal peak strain (GLS), circumferential peak strain (GCS), peak area strain (GAS) and radial peak strain (GRS) of overweight and obesity patients decreased significantly (R = 0.466, P <0.001), and GLS (r = 0.502, P <0.05). The ratio of pre-diastolic mitral inflow velocity to early peak LV strain rate (r / (P <0.001), GAS (r = 0.535, P <0.001), GRS (r = -0.554, P <0.001) were all correlated with body mass index (BMI) (R = 0.372, P = 0.003), GLS (r = 0.455, P <0.001), GCS 0.471, P <0.001) were associated with free fatty acid (FFA). Stepwise stepwise regression analysis showed that BMI was independently associated with E / e’sr, GLS, GCS, GAS and GRS. WHR and GLS, And GRS independently, FFA was independently associated with E / e’sr (P <0.05). Studies have shown that overweight and obese patients with changes in cardiac structure and left ventricular overall contraction, impaired diastolic function, BMI, WHR, FFA may be overweight, obese patients independent of cardiac function factors.