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目的探讨组织多普勒成像(DTI)技术在评价早期糖尿病心脏病变左室功能方面的临床应用价值。方法检测39例糖尿病患者和24例健康人心室舒张早期快速充盈波E峰峰值流速(E);心房收缩充盈波(A);E/A值,用Simpson法测量左室射血分数(EF)。再记录后室间隔、侧壁、前壁、下壁、前室间隔、后壁六个壁的瓣环、基底段两个位置的收缩期、舒张早期和舒张晚期运动峰值(分别为Sa,Ea,Aa)。结果左室舒张早期充盈峰值速度与心房收缩期充盈峰速度(E),左室舒张早期充盈峰值速度与心房收缩期充盈峰值速度的比值(E/A),左室射血分数(EF)差异均无统计学意义;左室心房收缩期峰值充盈速度(A)(68.00±10.08)高于对照组(60.17±90.45),差异有统计学意义(P<0.05)。糖尿病组下壁和前间隔瓣环Sa均小于对照组(P<0.01)。结论DTI技术为临床早期检测出糖尿病心脏病变左室功能变化提供一种无创性方法,在早期舒张功能异常的检测方面,频谱多普勒舒张参数A可能是比DTI舒张功能参数更敏感的指标;在收缩功能的检测方面,左室前间隔和下壁的瓣环是DTI检测较敏感的部位。
Objective To investigate the clinical value of tissue Doppler imaging (DTI) in the evaluation of left ventricular function in patients with early diabetic heart disease. Methods The echocardiographic peak flow velocity (E), the atrial contractile filling wave (A) and E / A value were measured in 39 diabetics and 24 healthy volunteers. The left ventricular ejection fraction (EF) . Recorded ventricular septum, lateral wall, anterior wall, inferior wall, anterior chamber septum, posterior wall of the six walls of the valve ring, basilar segment systolic, diastolic and diastolic motion peak (respectively Sa, Ea , Aa). Results The peak filling velocity and the peak filling velocity of atrial systole (E), the ratio of peak filling velocity to apex filling velocity (E / A), left ventricular ejection fraction (EF) (A) (68.00 ± 10.08) in left ventricular systolic phase was higher than that in control group (60.17 ± 90.45), the difference was statistically significant (P <0.05). The lower wall and anterior septal annulus Sa of diabetic group were less than those of the control group (P <0.01). Conclusion The DTI technique provides a noninvasive method for early detection of left ventricular function in patients with diabetic heart disease. In the early detection of diastolic dysfunction, spectral Doppler diastolic parameter A may be more sensitive than DTI diastolic function parameter. In the detection of systolic function, the anterior left ventricular septum and inferior annulus are more sensitive sites for DTI detection.