脉冲多普勒组织成像技术评价2型糖尿病患者的左室舒张功能

目的 探讨脉冲多普勒组织成像技术评价2型糖尿病患者左室舒张功能异常的实用价值。方法 2型糖尿病患者77例，对照组43例，采用脉冲多普勒组织成像技术测量其二尖瓣环6个位点的舒张早、晚期最大运动速度Em、Am及Em／Am比值；采用二尖瓣血流多普勒频谱测量二尖瓣舒张早、晚期最大血流速度E、A、E／A比值和等容舒张时间。结果 2型糖尿病组Em和Em／Am比值明显减低、A增高、E／A减低、等容舒张时间延长；Em／Am与E／A具良好相关性；PW-DTI和二尖瓣血流多普勒频谱对2型糖尿病患者组左室舒张功能异常的检出率分别为94．81％、79．22％（P〈0．005）。结论 脉冲多普勒组织成像与二尖瓣血流多普勒频谱均可检测出2型糖尿病患者的左室舒张功能受损，脉冲多普勒组织成像能够识别假性正常化模式，提高左室舒张功能异常诊断的准确性和敏感性，从而为糖尿病心肌病提供更早期的诊断依据。

Assessment of left ventricular diastolic function by pulsed Doppler tissue imaging in patients with type 2 diabetes mellitus

Objective To assess the value of pulsed Doppler tissue imaging (PW-DTI) in evaluating the left ventricular diastolic dysfunction (LVDD) in patients with type 2 diabetes mellitus (DM). Methods Seventy-seven type 2 diabetic patients and 43 healthy volunteers underwent PW-DTI and mitral inflow pulsed wave Doppler (MPWD). Six positions of the mitral annulus were measured by PW-DTI for early diastolic velocity (Em), end diastolic velocity (Am), Em/Am ratio. Early mitral inflow velocity (E), end mitral inflow velocity (A), left ventricular isovolumetric relaxation (IVRT) and E/A ratio were measured by MPWD. Results In the diabetic patients, Em, Em/Am and E/A ratios were significantly decreased and Am and A increased with prolonged IVRT. The two examination modalities showed a significant correlation between Em/Am and E/A. The detection rate of LVDD in the diabetic group was 94.81% by PW-DTI and 79.22% by MPWD. Conclusion PW-DTI and MPWD show a significant correlation in assessment of the left ventricular filling, but the former displays better performance in sensitive and accurate diastolic function evaluation and provides early evidence for of diabetic cardiomyopathy of due to its potent ability in differentiation of false-normal presentaitons.