2型糖尿病心肌背向散射积分及左室舒张功能变化的研究

 目的评价2型糖尿病(Diabetes mellitus,DM)患者心肌背向散射积分(Integrated backscatter,IBS)及左室舒张功能的变化.方法用脉冲多普勒超声心动图(Pulsed Doppler echocardiography,PDE)、多普勒组织显像(Dopplertissue imaging,DTI)技术及IBS技术测定40例2型DM患者、20例健康人二尖瓣口和肺静脉血流参数(Ep、Ap、ap)、二尖瓣环运动参数(Vs、Ve、Va)及心肌IBS参数(IBS、IBS%、CVIB).结果DM组Ap、ap、Va增高,Ep/Ap、Ve、Ve/Va降低(P＜0.05);DM组IBS%增高、CVIB减低(P＜0.05).结论2型DM患者早期存在舒张功能异常;DTI测定二尖瓣环运动速度评价左室舒张功能敏感而简便;IBS能早期反映DM患者心肌的组织学改变.

Myocardial integrated backscatter and left ventricular diastolic function in patients with type 2 diabetes mellitus

Objective To evaluate the changes of cardiac structure and function in patients with type 2 diabetes mellitus(DM).Methods Pulsed Doppler echocardiography (PDE), Doppler tissue imaging (DTI),and ultrasonic integrated backscatter (IBS) were examined in 40 patients with type 2 diabetes mellitus and 20 normal subjects.The following echocardiographic indices were investigated: the trans-mitral velocity, the pulmonary venous velocity, the mitral annulus velocity and the time averaged value of IBS , the calibrated time-averaged value of IBS (IBS%),and the magnitude of the cyclic variation of IBS (CVIB).Results (1) The indices of Ap,ap,and Va increased and the parameters of Ep/Ap,Ve, and Ve/Va decreased in diabetic patients (P<(0.05)). (2) The IBS% of septum and left ventricular posterior wall was significantly higher and the CVIB was significantly lower in diabetic patients than in control group (P<0.05).Conclusions (1)The diastolic dysfunction exists before the systolic function damage in patients with 2 type diabetes mellitus.(2) The assessment of mitral annulus velocity by DTI is a simple and more sensitive method than the other echocardiographic methods in evaluation of left ventricular diastolic dysfunction.(3) Ultrasonic integrated backscatter can be used as a means for early assessing myocardial histological changes in type 2 diabetes mellitus patients.