经胸超声心动图测定无冠状动脉狭窄的糖尿病患者左心室灌注量可行性的观察  

TTE for diabetic patients without coronary artery stenoses left ventricular perfusion flow measurement

作　　者：张洁[1] 樊继绪 周苏晋[2] 刘燕[1] 孙承波[1] 王燕[1] 李洪娥[1] 

机构地区：[1]江苏省连云港市第一人民医院超声科,523938 [2]广东省第二人民医院超声科

出　　处：《中国糖尿病杂志》2015年第6期536-539,共4页Chinese Journal of Diabetes

摘　　要：目的探讨常规经胸超声心动图(TTE)评估糖尿病患者左心室整体灌注功能的可行性及其与糖尿病病程的相关性。方法选取经冠状动脉造影证实无冠状动脉狭窄的T2DM患者(T2DM组)60例和健康对照(NC)者60名。采用多普勒和三维超声心动图测量冠状窦血流和左心室质量(LVM)。左心室整体灌注量由冠状窦血流量除以LVM计算所得,并分析其与糖尿病病程的相关性。结果与NC组比较,T2DM组LVM增加[(154.35±19.44)vs(163.00±17.94)g,P<0.05],静息时左心室灌注量减少[(6.04±4.77)vs(1.72±0.33)ml/(min·g),P<0.01]。静息时左心室整体灌注量与糖尿病病程呈负相关(r=-0.533,P=0.000)。结论 TTE可有效地检测出经冠状动脉造影证实无冠状动脉狭窄的糖尿病患者在静息时存在冠状动脉微血管功能障碍。糖尿病患者的左心室整体灌注量减少,且与其糖尿病病程呈负相关。Objective Feasibility evaluation of the thoracic echocardiography（TTE）for left ventricular whole perfusion function measurement in diabetic patients.And study the association between left ventricular whole perfusion function and the duration of T2 DM.Methods A total of 120 subjects were enrolled in this study including 60 T2 DM patients without coronary artery stenosis confirmed by coronary angiography（T2DM group）and 60 healthy controls（NC group）.Doppler and 3 d echocardiography were used to measure coronary sinus blood flow and left ventricular mass（left ventricular mass,LVM）respectively.Left ventricular whole perfusion was calculated as follows：coronary sinus blood flow divided by the number of left ventricular volume.The association between left ventricular whole perfusion function and the duration of T2 DM was analyzed.Results LVM increased in T2 DM group compared with NC group[（154.35±19.44）vs（163.00±17.94）g,P 〈0.05].Resting left ventricular perfusion significantly reduced in T2 DM group compared with NC group[（6.04±4.77）vs（1.72±0.33）ml/（min·g）,P 〈0.01].A negative correlation could be seen between resting left ventricular perfusion and diabetes duration（r=-0.533,P〈0.001）.Conclusion TTE can effectively detect the resting coronary microvascular dysfunction in diabetic patients without coronary stenosis confirmed by coronary angiography.Left ventricular whole perfusion decreased in T2 DM and have negative correlation with diabetes duration.

关 键 词：冠状动脉微血管功能障碍 糖尿病 左心室灌注 冠状窦血流 左心室质量 经胸超声心动图 

分 类 号：R587.2[医药卫生—内分泌] R540.45[医药卫生—内科学]