应用背向散射积分技术评价糖尿病心肌病变的临床研究

目的　应用背向散射积分技术研究糖尿病患者的心肌超声组织特征 ,旨在探讨背向散射积分 (integrated backscatter,IBS)参数测定在评价糖尿病患者心肌病变方面的临床应用价值。方法　采用 HP Sonos5 5 0 0型超声诊断仪 ,该机配置声学密度定量 -背向散射积分 (AD- IBS)联机采样分析软件 ,检测了 17例无微血管并发症的 2型糖尿病患者 (I组 )和 17例有微血管并发症的糖尿病患者 (II组 )以及 16例正常人 (对照组 )心肌的心动周期时间平均背向散射积分 (IBS)、背向散射积分标化值 (IBS% )、背向散射积分周期变异幅度 (CVIB)、背向散射积分跨壁梯度 (TGIB)等超声背向散射积分参数 ,采样部位为胸骨旁左室长轴切面室间隔及左室后壁心肌的中间段。同时测定糖尿病患者的糖化血红蛋白 (Hb A1c)水平。运用 t检验进行 3组受检者心肌超声背向散射积分参数的显著性检验 ,对糖尿病患者的 TGIB与Hb A1c进行相关性分析 ,P<0 .0 5定义为有统计学意义。结果　 (1)糖尿病 I组、II组室间隔及左室后壁心肌的 IBS%均明显高于对照组 ;(2 )糖尿病 I组、II组室间隔及左室后壁心肌的 CVIB均明显低于对照组 ;(3)糖尿病 I组、II组室间隔及左室后壁心肌的 TGIB均显著高于对照组 ;(4 )糖尿病 II组室间隔及左室后壁心肌的 IBS%均明显高于糖

Study on Myocardial Damage in Patients with Type 2 Diabetes Mellitus Using Ultrasonic Integrated Backscatter

Objective To evaluate the diagnostic value of ultrasonic integrated backscatter (IBS) technique in detecting myocardial damage in patients with type 2 diabetes mellitus.Methods Seventeen type 2 diabetes mellitus patients without cardiac microvascular complications,seventeen type 2 diabetes mellitus patients with cardiac microvascular complications and sixteen normal subjects were studied using Hewlett Packard Sonos echocardiographic system with AD-IBS.The time averaged value of IB(IBS),the calibrated time-averaged value of IB(IBS%),the magnitude of the cyclic variation of IB(CVIB),and the transmural gradient of IBS%(TGIB) were detected.The area of interest for backscatter measurements was placed in the septal wall and in the left ventricular posterior wall(parasternal long-axis view ).Glycosylated hemoglobin (HbA1c) was measured in the patients with type 2 diabetes mellitus.Intergroup differences were tested for significance by means of Student's tests.The correlation between TGIB and HbA1c was analyzed.Results 1.The IBS% of the septum and left ventricular posterior wall was significantly higher in diabetic patients than that in the control group.2.The CVIB of the septum and left ventricular posterior wall was significantly lower in diabetic patients than that in the control group.3.The TGIB values increased significantly in the patient group.4.The integrated backscatter parameters of patients with cardiac microvascular complications had significant difference from those of patients without cardiac microvascular complications.5.In diabetic patients,there was a significant correlation between glycosylated hemoglobin (HbA1c) and TGIB.Conclusions Ultrasonic integrated backscatter parameters are helpful in assessing myocardial damage sensitively and in determining of the degrees of myocardium injury in type 2 diabetes mellitus patients.