瞬时波减速度波强评价2型糖尿病患者左心室舒张功能的临床应用价值  

Clinical evaluation of left ventricular diastolic function in patients with type 2 diabetes mellitus using decelerating wave intensity

作　　者：高宇[1] 王建华[1] 黄晓玲[1] 张敏郁[1] 丁桂春[1] 牛鑫鑫[2] 杨鹏飞[2] 

机构地区：[1]北京军区总医院超声科,北京100700 [2]北京军区总医院内分泌科,北京100700

出　　处：《中华医学超声杂志（电子版）》2013年第3期189-193,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨瞬时减速度波强(W2)评价2型糖尿病患者左心室舒张功能的临床应用价值。方法选取2型糖尿病患者122例,其中单纯糖尿病患者55例(单纯糖尿病组),糖尿病合并高血压患者67例(糖尿病合并高血压组);另选取30名健康志愿者作为健康对照组。应用常规超声心动图检测3组受检者左心室舒张早期流速峰值(E)、左心室舒张晚期流速峰值(A),应用WI技术检测3组患者颈总动脉W2参数,采集肘静脉血检测空腹血糖、糖化血红蛋白。2型糖尿病患者进行为期2周的胰岛素泵强化治疗后重复检查以上参数。结果胰岛素泵强化治疗后,单纯糖尿病组与糖尿病合并高血压组患者的空腹血糖分别为(5.37±0.21)mmol/L、(5.40±0.33)mmol/L,低于治疗前的(10.80±2.56)mmol/L、(11.20±1.81)mmol/L,差异均有统计学意义(t=15.82、25.57,P均<0.05)。强化治疗前健康对照组受检者E、A、E/A、W2分别为(74.54±6.19)cm/s、(66.32±3.84)cm/s、1.35±0.86、(2266±912)mmHg·m/s,单纯糖尿病组患者上述指标分别为(68.08±9.75)cm/s、(77.38±5.97)cm/s、0.91±0.05、(1969±492)mmHg·m/s,糖尿病合并高血压组患者上述指标分别为(66.50±4.90)cm/s、(78.42±5.87)cm/s、0.88±0.09、(1967±417)mmHg·m/s,3组比较差异均有统计学意义(F=13.02、52.94、359.69、3.27,P均<0.05)。单纯糖尿病组患者E、E/A、W2较健康对照组受检者降低,差异均有统计学意义(q=6.43、7.14、12.43,P均﹤0.05);A较健康对照组受检者升高,差异有统计学意义(q=14.06,P<0.05)。糖尿病合并高血压组患者E、E/A、W2较健康对照组降低,差异均有统计学意义(q=7.14、42.89、3.35,P均<0.05);A较健康对照组升高,差异亦有统计学意义(q=14.06,P<0.05)。胰岛素泵强化治疗后,单纯糖尿病组E/A、W2分别为1.31±0.05、(2432±319)mmHg·m/s,糖尿病合并高血压组分别为0.91±0.14、(2059±188)mmHg·m/s。强化治疗后,单纯糖尿病组患者E/A、W2较强化治疗前升高,差异均有�Objective To evaluate the left ventricular diastolic function in patients with type 2 diabetes mellitus by using decelerating wave intensity and to investigate the clinical significance.Methods A total of 122 patients with type 2 diabetes and 30 healthy volunteers(NC group)were enrolled.The 122 patients with type 2 diabetes were divided into two groups:55 patients with diabetes in DM1 group and 67 patients with diabetes complicated with hypertension in DM2 group.In order to evaluate left ventricle diastolic function,all the subjects underwent examinations to measure left ventricular early diastolic peak velocity(E),left ventricular diastolic peak velocity(A),and E/A ratio by routine ultrasound cardiogram,and W2 arcuation parameters of common carotid artery by WI technology.Fasting venous blood glucose(FBG)and glycosylated hemoglobin were also collected and were reexamined after two-week intensive treatment with insulin pump for type 2 diabetes patients.Results After insulin treatment,the FBG were(5.37±0.21)mmol/L and(5.40±0.33)mmol/L in DM1 and DM2 group respectively,which were lower than before[(10.8±2.56)mmol/L and(11.20±1.81)mmol/L)].There were significant differences among the groups(t=15.82,25.57,both P<0.05).Before insulin treatment,E,A,E/A,W2 were(74.54±6.19)cm/s,(66.32±3.84)cm/s,1.35±0.86,(2266±912)mm Hg·m/s in NC group;were(68.08±9.75)cm/s,(77.38±5.97)cm/s,0.91±0.05,(1969±492)mm Hg·m/s in DM1group;and were(66.50±4.90)cm/s,(78.42±5.87)cm/s,0.88±0.09,(1967±417)mm Hg·m/s in DM2 group respectively.There were significant differences among the groups(F=13.02,52.94,359.69,3.27, all P<0.05).Between DM1 and NC group there were significant differences in E,E/A,W2 and A(q=6.43,7.14,12.43,14.06,all P<0.05).Between DM2 and NC group there were significant differences in E,E/A,W2 and A(q=7.14,42.89,3.35,14.06,all P<0.05).After insulin treatment,E/A,W2 were 1.31±0.05,(2432±319) mm Hg·m/s in DM1 group;and were 0.91±0.14,(2059±188) mmHg·m/s in DM2 group respectively.There were significant differen

关 键 词：超声心动描记术 糖尿病 2型 心室功能 左 瞬时波强 

分 类 号：R587.2[医药卫生—内分泌]