摘要
【目的】应用多普勒组织成像(Doppler tissue i maging,DIT)技术评价2型糖尿病患者左室功能;探讨高血压对糖尿病心脏结构和功能的影响。【方法】选择2型糖尿病(diabetes mellitus,DM)患者50例作为试验组,并分为正常血压糖尿病患者组(DM)和合并高血压糖尿病组(DM+HP)两个亚组。同时选50例健康体检者作为正常对照组(NC)。应用GE Vivid7超声诊断仪,行常规二维超声心动图检查,测量相应数据后转入TVI条件,分别测量各点收缩期峰值运动速度(Sa)、舒张早期峰值运动速度(Ea)、舒张晚期峰值运动速度(Aa),每个部位测量3个心动周期取平均值,并计算舒张早期与晚期峰值运动速度之比(Ea/Aa),计算6个位点平均值代表瓣环的整体运动速度。【结果】糖尿病两亚组左房内径(LA)、室间隔厚度(I VS)、左室后壁厚度(LVPW)及左室心肌质量指数(LVMI)与对照组比较均明显升高,射血分数(EF%)在DM亚组与NC组间无显著差异,而在DM+HP亚组则显著减低。糖尿病患者二尖瓣环6个位点的DTI频谱,各点的Ea/Aa<1。试验组与对照组二尖瓣环6个位点的组织多普勒速度测值各组侧壁、下壁、后壁运动速度均大于间隔、前壁,且侧壁运动速度最大。反映收缩功能的指标Sa在DM亚组与NC组之间无统计学差异,而在DM+HP亚组与DM亚组、NC组之间比较有显著的降低;反映舒张早期舒张功能的指标Ea在试验组明显低于对照组,DM+HP亚组和DM亚组之间比较无统计学差异;反映舒张晚期舒张功能的Aa在试验组明显高于对照组;此2指标在DM+HP亚组低于DM亚组;Ea/Aa试验组均低于对照组。【结论】组织多普勒技术可以早期无创评价糖尿病患者心脏的收缩和舒张功能,高血压加重糖尿病患者心脏结构和功能的损害。
[Objective] To evaluate the left ventricular function in nomaltensive and hypertensive patients with type 2 diabetes by Doppler tissue imaging （DTI） and survey the effectiveness of secondary hypernsion on the left ventricular structure and function in patients with type 2 diabetes. [Methods] Forty five patients with type 2 diabetes and 30 cases of healthy control were divided into three groups： DM, DM ＋ HP and healthy. Echocardiograpby was used to evaluate the left ventricular structure and function. Sa, Ea, Aa and Ea/Aa were measured and compared among healthy group, DM and DM ＋ HP group. [Results] Aa in group DM and DM ＋ HP were higher than that in healthy group, especially in group DM ＋ HP. Ea in group DM and DM ＋ HP were lower than those in healthy group. Sa in DM ＋ HP was lower than in DM and healthy group. [Conclusions] DTI can be used to evaluate the left ventricular systolic and diastolic function in patients with type 2 diabetes early and noninvasively. Hypertension aggravates the structure and function of left ventricle in patients with type 2 diabetes.
出处
《武警医学院学报》
CAS
2009年第9期777-780,共4页
Acta Academiae Medicinae CPAPF
