腺苷负荷心肌超声造影检测2型糖尿病患者心肌血流灌注异常  

Adenosine stress myocardial contrast echocardiography detects myocardial blood perfusion abnormalities in patients with type 2 diabetes mellitus

作　　者：李亚琼 田新桥 马玉磊 周琦 颜宁 鲁平 柴利杰 尹明慧 Li Yaqiong;Tian Xinqiao;Ma Yulei;Zhou Qi;Yan Ning;Lu Ping;Chai Lijie;Yin Minghui(Department of Ultrasonography,People′s Hospital of Zhengzhou University,Henan Provincial People′s Hospital,Fuwai Central China Cardiovascular Hospital,Zhengzhou 450003,China;Department of Endocrinology,People′s Hospital of Zhengzhou University,Henan Provincial People′s Hospital,Fuwai Central China Cardiovascular Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州大学人民医院河南省人民医院阜外华中心血管病医院超声科,450003 [2]郑州大学人民医院河南省人民医院阜外华中心血管病医院内分泌科,450003

出　　处：《中华超声影像学杂志》2020年第10期851-856,共6页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金-河南联合基金项目(U1704175)。

摘　　要：目的探讨腺苷负荷心肌超声造影检测2型糖尿病患者心肌血流灌注异常的临床应用价值。方法选取2019年5月至2020年1月阜外华中心血管病医院内分泌科临床诊断为2型糖尿病患者26例作为糖尿病组,同期性别、年龄相匹配的健康体检者28例为对照组,进行常规超声心动图、静息及腺苷负荷左心室心肌超声造影检查,脱机分析得出心肌灌注时间-强度曲线的平台期信号强度(A值)、曲线上升斜率(K值)及A×K值。结合年龄、性别、病程、体质指数、糖化血红蛋白水平等一般资料,对两组结果进行统计学分析。结果静息状态下,不论整体还是分节段,糖尿病组A值与对照组相比差异均无统计学意义(P>0.05),而糖尿病组心肌灌注参数K值及A×K值明显低于对照组,差异有统计学意义(均P<0.05);负荷状态下,不论整体还是分节段,糖尿病组心肌灌注参数的A值、K值及A×K值均明显低于对照组,差异有统计学意义(P<0.05);负荷状态心肌灌注异常的检出率明显高于静息状态,差异有统计学意义(P<0.05);糖尿病组的心肌血流量储备与其病程及糖化血红蛋白水平呈负相关(r=-0.580,P=0.020;r=-0.481,P=0.013)。结论腺苷负荷心肌超声造影可以检测2型糖尿病患者左室心肌血流灌注异常,具有重要的临床应用价值。Objective To explore the clinical value of adenosine stress myocardial contrast echocardiography in detecting myocardial blood perfusion abnormalities in patients with type 2 diabetes mellitus.Methods Twenty-six patients with type 2 diabetes mellitus clinically diagnosed from May 2019 to January 2020 in the endocrinology department of Fuwai Central China Cardiovascular Hospital and 28 healthy examinees with gender and age matched during the same period were enrolled.Routine echocardiography,rest and adenosine stress myocardial contrast echocardiography were performed,the plateau signal intensity(A value),curve rising slope(K value)and A×K value of the myocardial perfusion time-intensity curve were obtained by offline analysis.And general data such as age,gender,disease course,body mass index and glycated hemoglobin were collected,and results of the two groups were compared statistically.Results In the rest state,the A value of the myocardial perfusion parameter in the diabetic group was not significantly different from that of the control group,both in whole and in segments(P>0.05),while the K value and A×K value of the myocardial perfusion parameters in the diabetic group were significantly lower than those in the control group(P<0.05).In the stress state,the A value,K value and A×K value of myocardial perfusion parameters in the diabetic group were significantly lower than those in the control group,both in whole and in segments(P<0.05).The detection rate of myocardial perfusion abnormality in the stress state was significantly higher than that in the rest state,and the difference was statistically significant(P<0.05).The myocardial blood flow reserve in the diabetic group was negatively correlated with the course of disease and the level of glycated hemoglobin(r=-0.580,P=0.020;r=-0.481,P=0.013).Conclusions Adenosine stress myocardial contrast echocardiography can be used for detection of left ventricular myocardial perfusion abnormalities in patients with type 2 diabetes mellitus,which has great clinical ap

关 键 词：心肌血流灌注 2型糖尿病 腺苷负荷 心肌超声造影 

分 类 号：R587.2[医药卫生—内分泌] R542.2[医药卫生—内科学] R445.1[医药卫生—临床医学]