组织同步成像评价糖尿病心肌病左心室舒张同步性的研究  

Evaluation on left ventricular diastolic synchronicity in patients with diabetic cardiomyopathy by tissue synchronization imaging

作　　者：谷青[1] 卢川[2] 陈克彪[3] 

机构地区：[1]中国人民解放军第88医院超声科,山东泰安271000 [2]泰山医学院放射学院,山东泰安271000 [3]山东省泰安市中心医院心外科,山东泰安271000

出　　处：《医学影像学杂志》2013年第5期682-685,689,共5页Journal of Medical Imaging

摘　　要：目的探讨组织同步成像(TSI)对糖尿病心肌病(DCM)患者左心室舒张同步性的诊断价值。方法选择糖尿病心肌病患者30例和正常对照者30例进行超声心动图检查。在二维模式下测量左心房(LA)、左心室(LV)内径、室间隔厚度(IVSd)及左室射血分数(EF)。用脉冲频谱多普勒检测二尖瓣口舒张早期E峰流速(E)和舒张晚期A峰流速(A),计算E、A峰比值。在TSI模式下测量12个心肌节段舒张期达峰值速度时间(time to peak diastolic velocity,Te)、计算12个心肌节段Te的最大差值(Te-dif)和标准差(Te-SD)。结果 DCM组心肌各节段Te与正常对照组差异无统计学意义(P>0.05)。DCM组Te-SD和Te-dif与正常对照组差异非常显著(P<0.001)。DCM组不同性别之间Te、Te-SD和Te-dif无差异性(P>0.05)。50岁以上患者Te-SD和Te-dif较50岁以下的患者明显延长,差异显著(P≤0.05)。结论 DCM患者早期即出现心肌舒张不同步,年长者舒张不同步较年轻者显著。TSI技术可对其进行准确评价。Objective To evaluate the diastolic synchronicity of left ventricular （LV） with diabetic cardiomyopathy by tissue synchronization imaging （TSI）. Methods Consecutive thirty patients with diabetic cardiomyopathy were DCM group. Thirty healthy subjects without any cardiac diseases were control The LV ejection fraction and the anteroposterior diameter of the left atrium and left ventricle were measured by 2D. The Peak E velocity of the early diastolic wave （E） and the Peak A velocity of the late diastolic （A） wave were measured and the ratio of Peak E and Peak A was also calculated. TSI images of left ventricle （LV） were obtained simultaneously using GE Vivid 7 ultrasound imaging system and the time to peak diabetic velocity （Te） of twelve segments were measured. The maximal Te difference （Te-dif） and standard devia- tion of Te （Te-SD） of the 12 LV segments were analyzed. Results There was no statistical significance of Te between the two groups （ P 〉0.05）. There was extreme difference between the two groups in Te-SD and Te-dif （ P〈0. 001）. There was no difference in Te, Te-SD and Te-dif between males and females （ P 〉0.05）. In Group DCM, there was no differ- ence in Te of different age people （ P 〉0.05）, while Te-SD and Te-dif of the patients above 50 years old patients was ob- viously prolonged than that of the patients below 50 years old and the difference was remarkable （ P ≤0.05）. Conclusion The diastolic dissynehrony of LV in patients with DCM may occur in the early stage of DCM, however, its diastolic dissynchrony was more obvious in the aged people than in the younger people. TSI can offer the accurate and quick quantitative detection of the diastolic dissynchrony of LV for the patients with DCM.

关 键 词：组织同步成像 糖尿病心肌病 心肌舒张同步性 

分 类 号：R587.2[医药卫生—内分泌] R445.1[医药卫生—内科学]