心肌速度阶差评价无并发症糖尿病患者左心室功能  

Assessment of left ventricular function in diabetes mellitus patients without complications by myocardial velocity gradient

作　　者：张会欣[1] 李昭屏[1] 胡艳丽[3] 侯文芳[2] 盖迎利[4] 高炜[1] 

机构地区：[1]北京大学第三医院心内科,100191 [2]北京大学第三医院内分泌科,100191 [3]武警北京总队第二医院心内科 [4]北京航空航天大学医院

出　　处：《中华超声影像学杂志》2011年第4期290-293,共4页Chinese Journal of Ultrasonography

摘　　要：目的应用心肌速度分布图（MVP）测定心肌运动速度，计算心肌速度阶差（MVG），评价无l临床并发症糖尿病患者左心室功能。方法无并发症2型糖尿病患者30例，对照组30例。常规超声心动图检测左室结构及二尖瓣血流E／A、左室射血分数（LVEF）、左室短轴缩短率（LVFS），并计算左室质量指数（LVMI）；采用多普勒组织成像（DTI）测量二尖瓣环长轴方向收缩期峰值运动速度（Sm）、舒张早期运动速度（Em）与舒张晚期运动速度（Am）；应用MVP测量左室后壁心外膜和心内膜下心肌运动速度，计算收缩期和舒张期心肌速度阶差（MVGs、MVGd）。结果与对照组比较，糖尿病组左房、左室增大，室间隔增厚，LVMI增加（P〈0．05或P〈0．01），MVGs、MVGd、Em减低（P〈0．05或P〈0．01）；E／A、E／Em、Em／Am、Sm、LVEF、LVFS在两组间差异无统计学意义。结论糖尿病患者在临床并发症出现前已发生心脏结构及功能的改变；通过MVP获取心肌运动速度计算的MVG是评价左室心肌功能准确而敏感的指标。Objective To evaluate the structure and function of left ventricle in diabetes mellitus （DM） patients without complications by myocardial velocity gradient（MVG） measured by myocardial velocity profile （MVP）. Methods Thirty type 2 DM patients without complications and 30 healthy volunteers as controls were enrolled. The heart structure, systolic function and diastolic function of left ventricle were measured by echocardiography and the left ventricular mass index（LVMI） was calculated. Mitral annular systolic movement （Sm）, early rapid filling phase movement （Em） and atrial contraction movement（Am） were measured by tissue Doppler image and the left ventricular MVG at diastole and systole in subendocardium and subepicardium （MVGs, MVGd） were measured by MVP. Results The diameter of left atria and left ventricle, thickness of interventricular septum and LVMI were higher in DM group than those of control group （P 〈0.05 or P 〈0.01）, MVGs, MVGd, and Em were lower in DM group than those of control group（ P 〈0.05 or P 〈0.01）. There were no significant differences on E/A, Em/Am and E/Em between two groups. In addition, there were also no significant differences on Sm, left ventricular ejection fraction and left ventricular fraction shortening between two groups. Conclusions Structure and function of left ventricle have changed in patients of DM without complications. MVG measured by MVP is an accurate and sensitive index to assess left ventricular systolic and diastolic function.

关 键 词：超声心动描记术 糖尿病 2型 心室功能 左 心肌速度分布图 

分 类 号：R587.1[医药卫生—内分泌]