糖尿病患者左室超声背向散射改变的初步观察

目的　了解 2型糖尿病 (T2 DM)心肌背向散射 (IBS)变化的特点及其临床意义。　方法正常对照组 5 0例 ,T2 DM组 5 0例 ,病程≤ 5年 ,糖化血红蛋白 (Hb A1c) (9.6 9± 1.78) % ,应用HP5 5 0 0型超声诊断仪 ,在胸骨旁左室乳头肌短轴切面分别测量左心室前间壁、前壁、侧壁、后壁、下壁和后间隔心肌组织的 IBS,并将其与心包 IBS的比值作为心肌 IBS的校正值 (IB% ) ;舒张末期与收缩末期的差值即 CVIB,并将其与心包 IBS的比值作为心肌 CVIB的校正值 (CVIB% )。同时测定左室等容舒张期时间 (IVRT) ,二尖瓣血流图 E峰与 A峰的比值 (E/ A )。　结果　 T2 DM组心脏左室各室壁心肌背向散射参数与正常对照组比较 IB%增大 ,CVIB减低 ,差异非常显著 (P <0 .0 0 1) ,两组IVRT、E/ A均在正常范围 (P>0 .0 5 )。　结论　 T2 DM患者左室 IBS有明显的变化且呈弥漫性改变 ,左室 IBS的变化出现在舒张功能异常 (糖尿病心肌病亚临床期 )之前 ,背向散射技术可早期发现糖尿病心肌微结构的病变

Observation of myocardial ultrasonic intergrated backs catter in patients with type 2 diabetes mellitus

Objetive To study the characteristics and value of myocardial ultrasonic intergrated backscatter (IBS) in patients with type 2 diabetes mellitus. Methods Myocardial IBS were obtained from the left ventricular walls (anterior septum, anterior wall, lateral wall, posterior wall, inferior wall and posterior septum) with HP 5500 ultrasonic instrument in 50 patients with type 2 diabetes mellitus and 50 controls. The difference between diastasis and end systole is CVIB. The values of IBS and CVIB were normalized by the values of simultaneous pericardial IBS and CVIB (IB% and CVIB%). The left ventricular isovolumetric relaxation time (IVRT) and the ratio of peak E and A wave velocities of mitral valve rheography (E/A) were also determined. Results Compared with normal controls, IB% in the left ventricular walls were increased and CVIB were decreased with a significant differences ( P <0.001). IVRT and E/A were in normal ranges in two groups. Conclusion There were significant changes in left ventricular wall IBS and the changes were diffuse and preceded the abnormalities of left ventricular diastolic function (subclinical manifestation of diabetic myocardiopathy). IBS can very early find the presence of diabetic myocardial microstructural lesion