组织多普勒成像和Tei指数评价糖尿病及糖尿病伴高血压患者的左室功能

目的应用组织多普勒成像技术(TDI)和Tei指数评价正常血压糖尿病患者及合并高血压糖尿病患者的左室收缩舒张功能。方法选取30例血压正常的2型糖尿病患者(DM组)、30例合并高血压的2型糖尿病患者(DM+HT组)、30例高血压病不伴糖尿病患者(HT组)和30例健康体检者(NC组)。应用TDI技术测量左房室瓣环收缩期峰值速度(Sa)、舒张早期峰值速度(Ea)、舒张晚期峰值速度(Aa)、Ea/Aa,并根据左房室瓣环组织多普勒计算Tei指数。结果 DM+HT组Sa较NC组、DM组、HT组显著减低(P<0.01);DM组、DM+HT组、HT组的Ea、Ea/Aa均显著低于NC组(P<0.01),而DM+HT组又显著低于DM组、HT组,差异有统计学意义(P<0.01)。Aa在DM、DM+HT组、HT组与NC组之间比较差异均无统计学意义(P>0.05)。DM组、DM+HT组、HT组Tei指数均显著高于NC组(P<0.05),且DM+HT组Tei指数亦显著高于DM组、HT组,差异有统计学意义(P<0.01)。结论 TDI及Tei指数的联合应用可以敏感、准确地评价2型糖尿病患者的左室功能,而高血压加重糖尿病患者左室功能的损害。

Assessment of Left Ventricular Systolic and Diastolic Function by Tissue Doppler Imaging and Tei Index in Diabetes Mellitus Patients with and without Hypertension

Objective To assess left ventricular systolic and diastolic function in diabetes mellitus patients with and without hypertension by tissue doppler imaging(TDI) and Tei index.Methods The patients were divided into 4 groups:30 patients with type 2 diabetes mellitus alone(DM group),30 patients with both hypertension and type 2 diabetes mellitus(DM+HT group),30 patients with hypertension alone(HT group),and 30 control subjects(control group).Mitral annulus were measured by TDI,including peak systolic velocity(Sa),peak early diastolic velocity(Ea),peak end diastolic velocity(Aa),and Ea/Aa ratio.Tei index was also calculated from the results of TDI.Results Sa was significantly decreased in the DM+HT group compared with the control group,DM group and HT group(P<0.01).Ea and Ea/Aa were significantly lower in the DM group,DM+HT group and HT group compared with the control group(P<0.01).While Ea and Ea/Aa were significantly lower in the DM+HT group compared with the DM group and HT group(P<0.01).There were no significant differences in Aa between DM group,DM+HT group,HT group and control group(P>0.05).Tissue Doppler-derived Tei index were significantly higher in the DM group,DM+HT group and HT group compared with those of the control group(P<0.05),and the Tei index was also significantly higher in the DM+HT group compared with the DM group and HT group(P<0.01).Conclusion TDI combined with Tei index is a sensitive and accurate tool to evaluate LV function in diabetic patients.Hypertension can aggravate the impairment of LV function in diabetic patients.