应用心肌功能指数评价冠心病合并糖尿病患者右心室功能的价值  

Evaluation of right ventricular function in patients with coronary heart disease and diabetes mellitus by right ventricular myocardial performance index

作　　者：齐惠英[1] 周长钰[2] 郑刚[1] 

机构地区：[1]天津市第三医院心内科,300250 [2]天津医科大学第二医院心脏科

出　　处：《中国心血管杂志》2011年第2期104-108,共5页Chinese Journal of Cardiovascular Medicine

摘　　要：目的探讨应用右心室心肌功能指数(RVM P1)评价冠心病(CHD)合并糖尿病(DM)患者的右心室功能的价值。方法选取CHD患者51例、DM患者30例、CHD合并DM患者46例作为3个试验组,同时选取门诊健康体检者40名作为对照组。行常规二维超声心动图检查,测量左心房内径(LA)、左心室舒张末期内径(LVED)、右心室舒张末期内径(RVED)、左心室射血分数(LVEF)、右心房上下径(RA1)、有心房左右径(RA2)、二尖瓣血流E/A比值(MV E/A)。应用组织多普勒测量三尖瓣环的运动速度,并计算Tei指数及RVMPI。结果 3个试验组的Tei指数及右心室心肌舒张期功能指数(RVDMPI,CHD组:0.24±0.10,DM组:0.26±0.09,CHD+DM组:0.27±0.08)均较对照组(0.16±0.07)升高(P<0.01),而右心室心肌收缩期功能指数(RVSMPI,CHD组:0.22±0.06,DM组:0.22±0.06,CHD+DM组:0.23±0.07)与对照组(0.21±0.05)比较差异均无统计学意义(P>0.05)。结论 CHD和DM患者右心室舒张功能下降,RVMPI较Tei指数能更准确地评价右心室功能的改变。Objective To evaluate right ventricular function in patients of coronary heart disease （CHD） with diabetes mellitus （DM） by right ventricular myocardial performance index （ RVMPI ）. Methods Echocardiography were performed in 51 patients with CHD （CHD group）, 30 patients with DM （DM group）, 46 patients with CHD and DM （ CHD and DM group） and 40 normal subjects （ control group, NC ）. Left atrial diameter （ LA）, left ventricular end diastolic diameter （LVED）, right ventricular end diastolic diameter （RVED）, left ventricular ejection fraction （LVEF）, right atrial diameter （RA） and mitral valve E/A ratio （MV E/A ） were measured by conventional two-dimensional echocardiography. Velocities of the tricuspid annulus were measured by tissue Doppler imaging （TDI）. Tel index and RVMPI were also measured and calculated by TDI. Results Tel index and right ventricular diastolic myocardial performance index （RVDMPI, CHD group： 0. 24±0. 10, DM group： 0. 26±0. 09, CHD ＋ DM group： 0. 27 ±0. 08） in three experimental groups were higher than NC group （ RVDMPI： 0. 16 ±0. 07, P 〈 0. 01）. The differences of right ventricular systolic myocardial performance index （RVSMPI） among four groups were no statistical significance （CHD group： 0. 22±0. 06, DM group： 0. 22 ±0. 06, CHD ＋ DM group： 0. 23±0. 07, NC group： 0. 21±0.05, P 〉0.05）. Conclusions The left and right ventricular diastolic function in patients of CHD and DM were impaired. RVMPI were more accurate than Tei index about the evaluation of right ventricular function.

关 键 词：心室功能 右 冠状动脉疾病 糖尿病 

分 类 号：R541.4[医药卫生—心血管疾病] R587.1[医药卫生—内科学]