饮食控制对肥胖老年女性心功能的影响

目的 采用组织多普勒成像(TDI)技术评价饮食控制的无全身疾病的老年肥胖女性左心功能的效果. 方法入选100例无全身疾病肥胖老年女性,随机分为饮食控制组47例(3例退出)和非饮食控制组50例.另选健康正常体质量老年女性40例为对照组.饮食控制6个月(饮食给予相当于自身基础代谢率70%的低卡路里食物).以TDI技术测量其在二尖瓣瓣环6个取样点的收缩期、舒张早期和晚期峰值运动速度(Sm、Em和Am)及Em和Am比值(Era/Am),并计算各指标平均值(MSm、MEm、MAm和MEm/Am). 结果 6个月后饮食控制组较非饮食控制组体质指数(BMI)下降两组分别为(28.4±1.7)kg/m~2、(30.7±1.4)kg/m~2,P<0.05].收缩压和心率降低.饮食控制前后3组二尖瓣瓣环各取样点Sm、Em、Am和Em/Am及Mm、MEm、MAmt MEm/Am均差异有统计学意义(均P<0.05);但6个月后饮食控制组较非饮食控制组增加,MSm分别为(8.3±1.5)cm/s与(7.4±1.4)cm/s(P<0.05);饮食控制组基线自身比较,MSm(7.5±1.5)cm/s降低(P<0.05). 结论饮食控制有助于无全身疾病肥胖老年女性左心室收缩功能的改善.TDI技术是左心室局部和整体功能早期评价的理想检测手段.

Evaluation of the effect of diet control on left ventricular function in isolated obese elderly women by tissue Doppler imaging

Objective To investigate tissue Doppler imaging (TDI) assessing left ventricular function in isolated obese elderly women,and to analyze the effects of hypocalorie diet. Methods A total of 93 isolated obese elderly women were randomly divided into two groups: group Ⅰ with hypocaloric diet (equivalent 70% of basal metabolic rate n= 47) for 6 months, and group Ⅱ with normal diet (n=50). There were also 40 healthy normal weight elderly women as controls (group Ⅲ). All of them underwent TDI. The peak systolic velocity (Sm), peak early diastolic velocity (Em) and peak late diastolic velocity (Am) of six sites of mitral annulus were adopted. Em/Am were measured, and mean value of above indexes (MSm, MEre, MAre and MEm/Am) were calculated. Results Compared with group Ⅱ after 6 months, group Ⅰ had lower body mass inden (BMI) (28.4 ±1.7) kg/m~2 vs. (30.7±1.4) kg/m~2 , P<0.05], lower systolic blood pressure and slower heart rate. There were significant differences in Sm, Era, Am, Era/Am of all six sites of mitral annulus, and in mean value of above indexes between pre- and post- hypocaloric diet in all three groups. After 6 months, MSm was higher in group Ⅰ than in group Ⅱ (8.3±1.5) cm/s vs. (7.4±1.4)cm/s, P<0.05], and than in group Ⅰ at baseline (8.3±1.5) cm/s vs. (7.5±1.5) cm/s, P<0.05]. Conclusions Left ventricular function has become abnormal in isolated obese elderly women, and could be improved partly by diet control. Due to more sensitive than conventional echocardiography, TDI provides an ideal method to evaluate left ventricular local and general function early in isolated obese elderly women.