Tei指数对糖尿病患者右心功能的评价

目的:用脉冲组织多普勒(PW-TDI)技术测量右心Tei指数评价糖尿病患者右心功能并探讨Tei指数的临床价值。方法:将80例2型糖尿病患者按有无合并糖尿病心肌病分成糖尿病心肌病组(n=40)与单纯糖尿病组(n=40),另选择40例健康正常人作为对照组,常规做超声心动图检查得到右心构型数据[右室横径(RVD)、右房横径(RAD),右室游离壁厚度(RVFW)]并同时应用PW-TDI技术在标准心尖四腔观获得右室游离壁三尖瓣前叶瓣环PW-TDI频谱图,计算出右心Tei指数,比较单纯糖尿病组与糖尿病心肌病组及正常对照组的Tei指数。结果:糖尿病心肌病组较单纯糖尿病组Tei指数增加、单纯糖尿病组较正常对照组Tei指数增加,差异有统计学意义(P<0.05),糖尿病心肌病组较正常对照组Tei指数明显增加,差异有显著统计学意义(P<0.01);除RVFW各组差异均无统计学意义外,单纯糖尿病组较正常对照组右室构型数据比较差异无统计学意义(P>0.05),糖尿病心肌病组较单纯糖尿病组及正常对照组右心构型数据比较差异均有统计学意义(P<0.05)。结论:Tei指数是一个敏感、简便、快速评价糖尿病患者右心整体功能的指标。

Tissue Doppler Tei index for estimation of the right ventricular function in diabetic patients

Objective ： To conduct a measurement of the right ventricular function in patients with diabetes mellitus by applying pulsed wave tissue Doppler imaging（PW-TDI） for evaluation of the clinical value of pulsed Doppler Tel index. Methods ： Eighty patients with type 2 diabetes by presence of diabetic cardiomyopathy or not were allocated to diabetic cardiomyopathy group and simple diabetes group （ n = 40 for each） , and another 40 healthy subjects were included as controls. Conventional echocardiography was performed in the total subjects to measure the configuration parameter of the right hearts,including right ventricular transverse diameter（RVD） ,right atrium transverse diameter（RAD） and right ventrieular free wall thickness（RVFW） as well as the spec- tral PW-TDI in the right ventricle wall tricuspid valve ring via standard apical four-chamber view. The pulsed Doppler Tel indexes for the right ventricles were calculated and compared among the three groups. Results ： Increased Tel indexes were found in the groups of diabetic cardiomyopathy and simple dia- betes, and the increase was significant for patients with diabetic cardiomyopathy by comparison among the three groups （ P 〈 0.05 ）. The configuration pa- rameter in the right heart remained no statistical difference between simple diabetes group and controls, yet the difference was significant for diabetic car- diomyopathy group except for the parameter in RVFW（ P 〉 0.05 ）. Conclusion ： Pulsed Doppler Tel index may be sensitive, simple and quick marker for overall evaluation of the right ventricular function for patients with diabetes mellitus.