应用组织速度成像评价2型糖尿病肾病患者的左室整体收缩功能

目的应用定量组织速度成像技术（QTVI）及组织追踪法（TT）研究不同阶段2型糖尿病肾病（2-DN）患者的左室整体收缩功能，寻求左室整体收缩功能损害的早期诊断指标。方法60例2型糖尿病（2-DM）患者按尿白蛋白排泄率（UAER）分为3组：正常白蛋白尿（NAU）组、微量白蛋白尿（MAU）组及临床白蛋白尿（CAU）组。正常对照组（NC）30例。通过Simpson法测得左室射血分数（LVEF）；应用QTVI及TT获得左心室侧壁、后间隔、前壁、下壁、前间隔、后壁二尖瓣环处的收缩期峰值速度（Vs）、收缩期最大位移（D），6个室壁的平均Vs（AVs）、平均D（AD）。结果MAU组LVEF与NC组相比无统计学差异；MAU组、CAU组左室6个室壁二尖瓣环处Vs、D及AVs、AD低于NC组（P〈0．05或P〈0．01）；患者组AVs与LVEF、AD与LVEF呈高度正相关。结论QTVI及TT对2-DN左室整体收缩功能损害有很高的早期诊断价值。随着UAER增加，2-DN左室整体收缩功能损害不断加重。

Evaluation of Global Left Ventricular Systolic Function in Type 2 Diabetic Nephropathy Patients Using Tissue Velocity Imaging

Objective To evaluate the global left ventricular systolic function in type 2 diabetic nephropathy(2-DN) patients in various stages using quantitative tissue velocity imaging(QTVI) and tissue tracking(TT).Methods Sixty type 2 diabetic patients and 30 normal controls(NC) were included.On the basis of urinary albumin excretion rate(UAER),patients were classified into:no albuminuria in 20 patients,microalbuminuria in 20 and clinical buminuria in 20.We obtained the left ventricular ejection fraction(LVEF)with Simpson's method.The systolic peak velocity(Vs) and the systolic peak displacement(D) in 6 mitral annulus sites were measured with QTVI and TT.Results The Vs and D of 6 mitral annular sites and the 6-site corresponding averages of AVs and AD in the albuminuria groups were lower than those of the NC.There was significant correlation between AVs and LVEF as well as between VD and LVEF.Conclusions QTVI and TT possess easy,early and sensitive advantages.The global left ventricular systolic function in 2-DN was impaired progressively along with albuminuria severity.