速度向量成像结合多巴酚丁胺负荷试验评价射血分数正常的糖尿病患者左心室短轴收缩功能  

Evaluation of systolic function of left ventricular in the short axis views in diabetic patients with ejection fraction 〉50% with velocity vector imaging and dobutamine stress echocardiography

作　　者：卫张蕊[1] 张军[2] 朱永胜[2] 张海滨 朱霆[2] 施红[1] 

机构地区：[1]解放军第一一七医院超声科,杭州310013 [2]第四军医大学西京医院超声科 [3]解放军第二一〇医院超声科

出　　处：《中华超声影像学杂志》2013年第7期564-567,共4页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金（81271580）

摘　　要：目的应用速度向量成像结合多巴酚丁胺负荷试验评价射血分数（EF）正常的糖尿病（DM）患者左室短轴收缩功能。方法30例排除冠心病、高血压、瓣膜性心脏病、先天性心脏病，并且经常规的超声心动图检查EF值〉50％的DM患者，另选20例性别、年龄相匹配的健康志愿者作为对照，分别在静息状态、多巴酚丁胺负荷（10、20、30、40μg·kg^-1·min^-1）状态存储胸骨旁左室短轴基底段、中间段及心尖段动态二维图像。应用SygnoVVI软件进行脱机分析，获得各个节段的心肌最大收缩速度（Vs）、应变（ε）、应变率（SR）。结果对照组和DM组组内比较，自基底段至心尖段Vs、ε、SR均呈递减趋势。对照组和DM组间比较，静息状态下，DM组心尖段SR较对照组显著减低（P〈0．05），其余各指标与对照组的差异均无统计学意义；10μg·kg^-1·min^-1多巴酚丁胺负荷后，DM组中间段和心尖段的SR均较对照组显著减低（P〈0．05）；心尖段的Vs和￡亦较对照组显著减低（P〈0．05）；20μg·kg^-1·min^-1多巴酚丁胺负荷后，DM组基底段、中间段和心尖段的SR均较对照组显著减低（P〈0．05）；中间段和心尖段的Vs和ε亦较对照组显著减低（P〈0．05）。多巴酚丁胺最大负荷后，DM组各指标均较对照组显著减低（P〈0．05）。结论DM患者早期收缩功能的减退最早表现在心尖段的心肌组织；SR比Vs、ε更为敏感；多巴酚丁胺负荷试验与速度向量成像相结合，可以明显增加各指标检出糖尿病心肌收缩功能障碍的敏感性。Objective To evaluate the systolic function of left ventricle（LV） in the short axis views in diabetic patients with ejection fraction （EF） value 〉 50% with velocity vector imaging （VVI） and dobutamine stress echocardiography （DSE）. Methods 30 diabetic patients, which were excluded from coronary artery disease, hypertension, valvular heart diseases, congenital heart diseases, and EF value 〉50 by echocardiography, and 20 volunteers with age and sex matched were involved in the study. Two- dimensional VVI eehoeardiographie cine loops were stored at baseline and dobutamine stress （10,20,30 and 40 μg·kg^-1·min^-1） in the basal, middle and apical short axis views of LV. The maximum systolic velocity （Vs）,strain （ε） and strain rate （SR） were obtained from sygno VVI software. Results The Vs,ε and SR showed decrement tendency from basal to apical short axis view whether in the control group or in the DM group. At baseline,the SR in the apical view decreased significantly in the DM group than that in the control group （P〈0.05）, other parameters were comparable between the two groups. After 10 μg·kg^-1·min^-1 dobutamine stress, the SR in the middle and apical views and Vs, e in the apical view decreased significantly in the DM group than those in the control group （all P〈0.05）. After 20 μg·kg^-1·min^-1 dobutamine stress,the SR in the basal,middle and apical views and Vs,ε in the middle and apical views decreased significantly in the DM group than those in the control group （all P〈0.05）.After the maximum dobutamine stress,all parameters decreased significantly in the DM group than those in the control group （all P〈0.05）. Conclusions The systolic function impairment of DM patients appeared first in the apical tissue of LV,SR was more sensitive index than velocity and strain,DSE could increase the sensitivity of VVI parameters in detecting the myocardial systolic function impairment in the earlier stage.

关 键 词：超声心动描记术 压力 糖尿病 心室功能 左 多巴酚丁胺 速度向量成像 

分 类 号：R445.1[医药卫生—影像医学与核医学]