应用心脏超声组织多普勒技术评估2型糖尿病合并非酒精性脂肪肝患者的心功能改变特点  

Evaluation of the characteristics of cardiac function changes in T2DM patients with NAFLD by echocardiography and tissue Doppler imaging

作　　者：杨晓燕[1] 罗安果[2] 高雪花 YANG Xiao-yan;LUO An-guo;GAO Xue-hua(Department of Special Inspection,Chengdu Seventh People's Hospital,Chengdu 610072,China;Department of Cardiovascular Ultrasound and Non-invasive Cardiology,Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital,Chengdu 610072,China)

机构地区：[1]成都市第七人民医院特检科,四川成都610041 [2]四川省医学科学院·四川省人民医院心脏超声及心功能科,四川成都610072

出　　处：《实用医院临床杂志》2019年第4期33-36,共4页Practical Journal of Clinical Medicine

基　　金：四川省干部保健科研课题(编号:川干研2017-204)

摘　　要：目的应用心脏超声及组织多普勒技术评估2型糖尿病合并非酒精性脂肪肝患者的早期心功能改变特点。方法临床明确诊断2型糖尿病患者253例,根据肝脏B超检查是否合并非酒精性脂肪肝分为研究组178例,对照组75例。两组均行心脏超声及组织多普勒检查评估心脏功能,比较两组各种参数,并比较不同舒张功能分级患者中发生非酒精性脂肪肝的概率。结果研究组患者左室射血分数及e’峰速度低于对照组;左房容积指数、E峰速度/e’峰速度比值、等容舒张时间常数、左室舒张末期压力、左室舒张末期压力容积比高于对照组,差异均有统计学意义(P<0. 05)。随左室舒张功能不全的评级程度增加,患者发生非酒精性脂肪肝的概率亦增加,差异有统计学意义(P<0. 01)。结论 2型糖尿病合并非酒精性脂肪肝患者存在心脏舒张功能降低;在2型糖尿病患者中,随着心脏舒张功能的降低,发生非酒精性脂肪肝的概率亦增加。Objective To assess the early changes of the cardiac functional feature in the T2DM patients with NAFLD by using echocardiography and tissue Doppler imaging.Methods A total of 253 T2DM patients were divided into study and control groups according to the results of the liver examination by ultrasound.Patients in the study group were diagnosed as nonalcoholic fatty liver disease (NAFLD,N = 178) while the others in the control group were not diagnosed as NAFLD (N = 75).All the patients were examined with the echocardiography and tissue Doppler imaging and all the parameters were compared between the two groups.The incidence of NAFLD in patients with different diastolic function grading was also compared.Results The LV ejection fraction and e’peak flow were lower in the study group than those in the control group (P<0. 05) while the left atrial volume index,ratio of E velocity to e’ velocity,diastolic time constant (Tau),left ventricrlarend diastolic pressure (LV-EDP) and Left ventricular end-diastolic pressure-volume (LVEDP/EDV) ratio were higher than those in the control group (p<0. 05).The NAFLD patients were found more in the patients with more severity of LVDD (P<0. 01).Conclusion The2 DM patients who with NAFLD have the left ventricular diastolic dysfunction (LVDD)features and NAFLD patients are found more in the T2DM patients who with worse LVDD.

关 键 词：2型糖尿病 非酒精性脂肪肝 左室舒张功能降低 

分 类 号：R589.2[医药卫生—内分泌]