瞬时波强技术结合组织多普勒技术评价单纯2型糖尿病患者心血管功能的临床研究  

Research of cardiovascular function in patients with type 2 diabetes by wave intensity and tissue Doppler imaging

作　　者：何娟 郝力丹[2] 郭瑞强[2] 陈金玲[2] 

机构地区：[1]宜昌市中心人民医院超声科,443003 [2]武汉大学人民医院超声科,430060

出　　处：《中华超声影像学杂志》2013年第10期851-856,共6页Chinese Journal of Ultrasonography

摘　　要：目的 探讨瞬时波强（wave intensity,WI）和组织多普勒（tissue Doppler imaging,TDI）技术早期评估2型糖尿病患者心血管功能的临床意义.方法 糖尿病患者30例,其中15例病程1～5年（糖尿病1组）,15例病程＞5年（糖尿病2组）；对照组为30例健康志愿者.应用WI技术对3组受检者左侧颈总动脉进行检测,获得瞬时加速度波强（W1）、瞬时减速度波强（W2）、负向波面积（NA）、心电图R波顶点到W1顶点的时间（R-W1）、W1顶点到W2顶点的时间（W1-W2）、血管压力-应变弹性模量（Ep）、血管僵硬度（β）、血管顺应性（AC）、经β计算得出的局部脉搏波传播速度（PWVβ）、颈总动脉内-中膜厚度（IMT）等参数；超声心动图测量左室大小、左室射血分数（LVEF）、射血时间（LVET）、舒张早期峰值速度（E）、舒张晚期峰值速度（A）、E/A、等容舒张时间（IVRT）；应用TDI技术获得二尖瓣环水平舒张早期峰值速度（Em）,舒张晚期峰值速度（Am）、Em/Am;将三组参数进行比较.结果 ①糖尿病1组和2组β、PWVβ、Ep较对照组显著增大（P＜0.01,P＜0.05）,AC较对照组降低（P＜0.05）,糖尿病2组IMT较对照组显著增高（P＜0.01）,糖尿病2组PWVβ、Ep、IMT较糖尿病1组增大（P＜0.05）.②糖尿病2组W2较对照组、糖尿病1组显著升高（P ＜0.01,P＜0.05）.③糖尿病1、2组E/A、Em、Em/Am均较对照组显著降低（P ＜0.05,P＜0.01）；糖尿病2组Em较1组降低（P＜0.05）.④糖尿病组中,IMT与Ep、β、PWVβ呈显著正相关（r =0.48,P＜0.01;r=0.385,P＜0.05;r =0.478,P＜0.01）；Em与E呈正相关（r =0.404,P＜0.05）；Em/Am与E/Em、E/A呈显著正相关（r =0.602,r=0.559,P＜0.01）；Em与IVRT呈显著负相关（r=-0.653,P＜0.01）；W1与LVEF呈显著正相关（r =0.627,P＜0.01）,W1-W2与LVET呈显著正相关（r=0.847,P＜0.01）；W2与各舒张功能参数均无相关.结论 单纯糖尿病患者颈总动脉血管�Objective To evaluate the clinical value of cardiovascular function in patients with type 2 diabetes mellitus by wave intensity and tissue Doppler imaging.Methods According to the course of disease,30 patients with type 2 diabetes mellitus were divided in to two groups：T2DM group 1,the course of disease between 1 year to 5 years; T2DM group 2,the course of disease was longer than 5 years.30healthy volunteers were considered as control group.The parameters of accelerating wave intensity（W1）,decelerating wave intensity（W2）,negative area（NA）,time interval between the R-wave of ECG and the first peak（R-W1）,the first and second peaks （W1-W2）,elasticity modulus （Ep）,stiffness index （β）,arterial compliance（AC）,pulse wave velocity（PWVβ） and intima media thickness （IMT） were calculated by wave intensity.The left ventricular ejection fraction （LVEF）,left ventricular ejection time （LVET）,early diastolic peak speed （E）,late diastolic peak velocity （A）,E / A and isovolumic relaxation time（IVRT） were detected by two dimensional echocardiography.Mitral annular early diastolic peak speeds （Em）,late diastolic peak velocity （Am） and Em / Am were detected by tissue Doppler imaging.Then three groups data were recorded and compared.Results Compared with the control group,β,PWVβ,Ep in T2DM group increased significantly（P ＜0.01 or P ＜0.05）,while AC decreased（P ＜0.05）.IMT in T2DM group 2 was thicker significantly than the control group（P ＜0.01）.PWVβ,Ep,IMT in T2DM group 2 were significantly higher than those of T2DM group 1 （P ＜0.05）.W2 in T2DM group 2 was significantly higher than those of T2DM group 1 and the control group（P ＜0.01 or P ＜0.05）.E/A,Em and Em/Am in T2DM group were significantly lower than those of the control group （P ＜0.05 or P ＜0.01）.Compared with T2DM group 1,Em in T2DM group 2 decreased significantly（P ＜0.05）.In T2DM group,there were positive correlation between IMT and Ep,β,PWVβ （r =0.48,r =

关 键 词：超声心动描记术 糖尿病 2型 心室功能 左 血液动力学现象 瞬时波强 

分 类 号：R445.1[医药卫生—影像医学与核医学] R587.1[医药卫生—诊断学]