组织多普勒技术对2型糖尿病性心脏病患者右室功能的研究
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摘要
目的探讨组织多普勒技术评价2型糖尿病性心脏病患者右室功能的应用价值。方法选取单纯2型糖尿病性心脏病患者30例(糖尿病组)和健康志愿者30例(正常对照组),两组均行常规超声心动图检查后,再应用M型超声测量右室侧壁三尖瓣环收缩期位移(TAPSE),脉冲多普勒检测三尖瓣口舒张期早、晚期峰值流速(E、A),并计算E/A;Simpson法测量右室射血分数(RVEF);组织多普勒技术分析右室侧壁三尖瓣环处等容收缩期速度(IVCv)、收缩期运动速度(Vs)、舒张期早、晚期运动速度(Ve、Va),并计算IVCv/Vs和Ve/Va值,比较两组上述参数的差异。结果糖尿病组与正常对照组的RVEF、TAPSE均正常,两组比较差异均无统计学意义。糖尿病组Vs和Ve/Va值较正常对照组减低,IVCv和IVCv/Vs值均较正常对照组增高,差异均有统计学意义(均P<0.05)。结论 2型糖尿病性心脏病患者存在右室舒张、收缩功能异常,组织多普勒技术可为评价右室功能提供更为敏感的定量指标。
Objective To explore the application value of tissue Doppler imaging(TDI)in evaluating right ventricular function in patients with type2 diabetes mellitus(T2 DM).Methods Thirty patients with T2 DM and 30 health people(control group) were enrolled.After conventional examination by two dimensional echocardiography,the tricuspid annulus systolic offset was measured by M mode ultrasound.Right ventricular systolic function ejection fraction(RVEF) was obtained by Simpson's method.Diastolic early and late phrase blood flow velocity(E,V) and(E/A) were measured by pulse wave Doppler.The right ventricular function imaging was acquired by TDI,the isovolumic contraction velocity(IVCv),systolic velocity(Vs),the diastolic early and late stage movemen velocity of tricuspid annulus(Ve,Va) were recorded,IVCv/Vs and Ve/Va were calculated.The difference of these parameters above were compared between two groups.Results RVEF and TAPES were normal in T2 DM patients and control group,there were no significant difference.IVCv and IVCv/Vs in T2 DM patients were significantly higher than those in control group,Vs and Ve/Va in T2 DM patients were significantly lower than those in control group,there were significant differences(all P<0.05).Conclusion TDI could be used accurately,noninvasively to determine right ventricular function in T2 DM patients.Right ventricular function in patients with T2 DM is decreases compared with normal control subjects.
Objective To explore the application value of tissue Doppler imaging(TDI)in evaluating right ventricular function in patients with type2 diabetes mellitus(T2 DM).Methods Thirty patients with T2 DM and 30 health people(control group) were enrolled.After conventional examination by two dimensional echocardiography,the tricuspid annulus systolic offset was measured by M mode ultrasound.Right ventricular systolic function ejection fraction(RVEF) was obtained by Simpson's method.Diastolic early and late phrase blood flow velocity(E,V) and(E/A) were measured by pulse wave Doppler.The right ventricular function imaging was acquired by TDI,the isovolumic contraction velocity(IVCv),systolic velocity(Vs),the diastolic early and late stage movemen velocity of tricuspid annulus(Ve,Va) were recorded,IVCv/Vs and Ve/Va were calculated.The difference of these parameters above were compared between two groups.Results RVEF and TAPES were normal in T2 DM patients and control group,there were no significant difference.IVCv and IVCv/Vs in T2 DM patients were significantly higher than those in control group,Vs and Ve/Va in T2 DM patients were significantly lower than those in control group,there were significant differences(all P<0.05).Conclusion TDI could be used accurately,noninvasively to determine right ventricular function in T2 DM patients.Right ventricular function in patients with T2 DM is decreases compared with normal control subjects.
引文
[1]胡延,张萍.糖尿病与非糖尿病青年心肌梗死的临床分析[J].中国糖尿病杂志,2017,25(6):493-496.
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[5]陈彦玲,周长钰,郑成环,等.二维超声组合多普勒评估糖尿病患者心肌功能[J].天津医科大学学报,2010,16(1):174-176.
[6]仉晓,田家凯,李晓燕,等.应变和应变率对早期发现糖尿病性心肌病的应用价值[J].中国超声诊断杂志,2007,16(1):33-35.
[7]Miller D,Farah MG,Liner A,et al.The relation between quantitative right ventricular ejection fraction and indices of tricuspid annular motion and myocardial performance[J].J Am Soc Echo,2004,17(5):443-447.
[8]Vogel M,Schmidt MR,Kristiansen SB,et al.Validation of myocardial acceleration during isovolumic contraction as a novel noninvasive index of right ventricular contractility:comparison with ventricular pressure-volume relations in an animal model[J].Circulation,2002,105(14):1693-1699.
[9]马秀丽,刘书丽,苑宁,等.TDI等容收缩期参数评价2型糖尿病患者左右心室收缩功能[J].中国医学计算机成像杂志,2013,19(2):168-171.
[2]Rudski LG,Lai WW,Afilalo J,et al.Guidelines for the echocardiographic assessment of the right heart in adults:a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography,a registered branch of the European Society of Cardiology,and the Canadian Society of Echocardiography[J].J Am Soc Echocardiogr,2010,23(7):786-788.
[3]Yang W,Lu J,Weng J,et al.Prevalence of diabetes among men and women in China[J].N Engl J Med,2010,362(12):1090-1101.
[4]闻小林,王玲,郑言言,等.二维斑点追踪成像技术评价2型糖尿病患者右室心肌纵向应变及应变率[J].中华超声影像学杂志,2012,21(9):762-766.
[5]陈彦玲,周长钰,郑成环,等.二维超声组合多普勒评估糖尿病患者心肌功能[J].天津医科大学学报,2010,16(1):174-176.
[6]仉晓,田家凯,李晓燕,等.应变和应变率对早期发现糖尿病性心肌病的应用价值[J].中国超声诊断杂志,2007,16(1):33-35.
[7]Miller D,Farah MG,Liner A,et al.The relation between quantitative right ventricular ejection fraction and indices of tricuspid annular motion and myocardial performance[J].J Am Soc Echo,2004,17(5):443-447.
[8]Vogel M,Schmidt MR,Kristiansen SB,et al.Validation of myocardial acceleration during isovolumic contraction as a novel noninvasive index of right ventricular contractility:comparison with ventricular pressure-volume relations in an animal model[J].Circulation,2002,105(14):1693-1699.
[9]马秀丽,刘书丽,苑宁,等.TDI等容收缩期参数评价2型糖尿病患者左右心室收缩功能[J].中国医学计算机成像杂志,2013,19(2):168-171.