超声心动图对中青年2型糖尿病患者左心室功能的评价  

Evaluation of the left ventricular function of the younger type 2 diabetes mellitus patients by echocardiography

作　　者：康彧[1] 王竞[1] 沙晓溪[1] 康佳[1] 胡敏[1] 王渠[1] 张嬿[1] 

机构地区：[1]成都中医药大学附属医院超声医学科,四川成都610072

出　　处：《西部医学》2017年第10期1461-1464,1468,共5页Medical Journal of West China

基　　金：国家中医药管理局中医临床研究基底建设项目(JDZX2015218);成都中医药大学附属医院基金支持项目(2012-D-YY-15)

摘　　要：目的应用超声心动图评价中青年2型糖尿病(T2DM)患者的左心室功能。方法纳入34~49岁的2型糖尿病患者73例。根据HbA1c水平分为T2DM-Ⅰ组(HbA1c<7%)40例和T2DM-Ⅱ组(HbA1c>7%)33例,另纳入正常对照组35例。常规测量心腔大小、左心室射血分数(LVEF)和二尖瓣前向血流舒张早期、舒张晚期峰值流速比值(E/A)。应用超声心动图脉冲多普勒和组织多普勒(TDI)技术分析上述3组人群左心室E/e’和Tei指数;应用二维斑点追踪技术(2D-STI)分析左心室整体长轴应变(GLS)。结果传统指标LVEF和E/A在评价中青年T2DM患者左心室收缩功能和舒张功能方面,3组间比较差异无统计学意义(P<0.05)。左心室舒张功能指标E/e’:T2DM-Ⅰ组与T2DM-Ⅱ组均较正常对照组增加(P<0.01),T2DM-Ⅱ组较T2DM-Ⅰ组受损更严重(P<0.05)。左心室收缩功能指标GLS:T2DM-Ⅰ组与正常对照组差异无统计学意义(P>0.05),T2DM-Ⅱ组较T2DM-Ⅰ和正常对照组均减低(P<0.05)。左心室整体功能指标Tei指数:T2DM-Ⅰ组与正常对照组无差异(P>0.05),T2DM-Ⅱ组较T2DM-Ⅰ和正常对照组均增高(P<0.05)。结论超声心动图指标E/e’、Tei指数和GLS可早期检出血糖控制不佳中青年T2DM患者亚临床左心室功能减低,左心室舒张功能受损先于收缩功能。Objective To explore the left ventricular function of younger type 2 diabetes mellitus （T2DM） patients by echocardiography. Methods 73 patients with T2DM were enrolled in the study. Accord- ing to glycated hemoglobin （HbAlc） control level, the patients were divided into T2DM-I group （HbA1C〈 7%, n=40） and T2DM-]] group （HbA1C≥7%, n=33）. 35 matched volunteers were chosen as control group. Two-dimensional echocardiography was used to measure the size of cardiac chamber and left ventricular ejection fraction （LVEF）. The mitral valve blood flow peak early diastolic velocity （E）, peak later diastolic velocity （A）, anterior mitral annulus diastolic peak velocity （e＇）, E/A, E/e＇ and Tel index measured by the pulsed wave Doppler and tissue Doppler imaging （TDI）. Two-dimensional speckle tracking imaging （2D-STI） was used to analyze the global longitudinal systolic strain （GLS） of left ventricle, Results There were no sta- tistical differences in the E/A and LVEF among three groups（P〉0.05）. The E/e＇ was statistical difference in the control and T2DM- I group （P〈0.01）, T2DM- I and T2DM- Ⅱ group （P〈0.05）. The GLS was de- creased in T2DM-Ⅱ group, and significant difference was found when comparing T2DM-Ⅱ group with T2DM- Ⅰ group （P〈0.05）. Tel index was increased in T2DM-Ⅱ group, and there was statistical difference comparing with T2DM- I group （P〈0.05）. Conclusion The new technical parameters E/e＇, Tei index and GLS of echocardiography could reflect the reduction of sub-clinical left ventricular function in T2DM younger patients with poor blood glucose control in the early stage, and the left ventricular diastolic function impaired earlier than systolic function.

关 键 词：超声心动描记术 2型糖尿病 左心室功能 

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]