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目的探讨组织多普勒成像(TDI)技术在评价早期2型糖尿病患者(T2DM)左室功能方面的临床应用价值。方法对早期T2DM患者(T2DM组)及正常组(NC组)各45例,应用TDI技术检测二尖瓣环左室壁侧运动频谱,测量收缩期、舒张早期、舒张晚期运动峰值(分别为Vs、Ve、Va),并计算Ve/Va;应用脉冲多普勒(PDE)检测二尖瓣口血流频谱,测量二尖瓣口舒张早期、舒张晚期血流速度(分别为E、A),并计算E/A;常规超声心动图用Simpson′s法测量左室射血分数(LVEF)。结果收缩功能指标:T2DM组与NC组的LVEF均在正常范围,差异无统计学意义(P>0.05),而T2DM组二尖瓣环室壁侧Vs低于NC组(P<0.05)。舒张功能指标:T2DM组Ve、Ve/Va、E/A均低于NC组(P均<0.05);T2DM组Va、A均高于NC组(P均<0.05);T2DM组舒张功能异常检出率TDI法为51.1%,高于PDE法的26.7%(P<0.01)。结论 T2DM患者早期即存在舒张、收缩功能异常,TDI技术测量二尖瓣环运动速度可为评价左心室功能提供新的、更为敏感的定量指标。
Objective To investigate the clinical value of tissue Doppler imaging (TDI) in evaluating left ventricular function in patients with early stage type 2 diabetes mellitus (T2DM). Methods Twenty-five patients with early T2DM (T2DM) and 45 normal controls (NC) were enrolled in this study. The left ventricular wall motion spectrum of mitral annulus was detected by TDI. The peak systolic, early diastolic and late diastolic velocities (Vs , Ve, Va) were calculated and Ve / Va was calculated. Pulse wave Doppler (PDE) was used to detect the mitral valve flow spectrum, and the early and late diastolic velocities (E and A, And E / A was calculated. Conventional echocardiography Left ventricular ejection fraction (LVEF) was measured by Simpson’s method. Results The indexes of systolic function: The LVEF of T2DM group and NC group were in the normal range, with no significant difference (P> 0.05). The Vs of mitral annular wall in T2DM group was lower than that of NC group (P <0.05). The indexes of diastolic function: The levels of Ve, Ve / Va and E / A in T2DM group were lower than those in NC group (all P <0.05). The levels of Va and A in T2DM group were higher than those in NC group (all P <0.05) The rate of TDI was 51.1%, higher than that of PDE (26.7%, P <0.01). Conclusion Diastolic and systolic dysfunction exist in early stage of T2DM patients. Measurement of mitral annulus velocity with TDI technique may provide a new and more sensitive quantitative index for evaluating left ventricular function.