多普勒超声心动图对糖代谢异常患者左心室舒张功能的研究

目的　评价不同糖代谢异常患者的心脏结构和舒张功能。方法　选择 6 3例中老年男性患者 ,其中正常糖耐量 (NGT)、糖耐量减低 (IGT)、糖尿病 (DM)患者分别为 2 0、2 2、2 1例 ,排除了高血压、有冠心病症状和心电图异常者 ,对每人进行多普勒超声心动图检查 ,记录常规二维超声结果及二尖瓣和肺静脉血流频谱 ,以评价其心脏舒张功能。用方差分析和q检验比较组间差异。结果　NGT组E/A比值 (二尖瓣E、A峰最大流速比值 )大于 1,IGT组和DM组小于 1,差异有显著性意义 ;左室快速充盈减速时间 (DT)DM组大于NGT、IGT组 ,差异有显著性意义 ;肺静脉 二尖瓣A峰时间差均小于 0 ,DM组高于IGT组和NGT组 ,三组间比较差异均有统计学意义 ;二尖瓣A峰速度时间积分DM组均大于IGT组、NGT组 ,但只有DM组与NGT组有统计学意义 ;二尖瓣A峰最大流速和二尖瓣A峰时间DM组均大于IGT组和NGT组 ;心房收缩期肺静脉逆流加速时间 (PA AT)DM组明显延长 ,而NGT组和IGT组无差别。结论　糖尿病患者及IGT患者与正常人比较均有左室弛张障碍及左室顺应性下降 ,IGT患者左室舒张功能减退程度较糖尿病组轻。

Study on diastolic function of left ventricle by means of Doppler echocardiogram in patients with abnormal carbohydrate metabolism

Objective To evaluate the left ventricular diastolic function of the patients with diabetes and impaired glucose tolerance.Methods Doppler echocardiographic examination was performed in 63 male patients without CHD and hypertension.Routine 2 dimensional echocardiogram,mitral and pulmonary venous flow velocity were recorded.The patients were classified into diabetes mellitus (DM),impaired glucose tolerances(IGT) and normal glucose tolerance(NGT) based on well standardized criteria of WHO.All values were expressed as ±s.One way analysis of variance and q test were used for comparison of the mean values.Results No difference in records of routine 2 dimensional echocardiography was found among 3 groups.E/A (the ratio of the early to late peak velocity) was lower in those with DM or IGT than in NGT.Deceleration time of early left ventricular filling (DT) was significantly longer in those with DM than in the NGT and IGT.,The disparity in A wave time of pulmonary vein and mitral valve in DM patients was lower than that in NGT and IGT subjects.Mitral valve A wave and pulmonary vein A wave were higher in DM patients than in IGT and NGT respectively.Conclusion Early abnormalities of cardiac diastolic function could be observed not only in DM patients,but also in those with impaired glucose tolerance,independent of CHD and hypertension.