组织多普勒超声Tei指数评价糖尿病肾病心室功能的研究

The Tei index of the ventricular function of the patients with diabetic nephropathy by tissue Doppler imaging

目的探讨组织多普勒(TDI)测定糖尿病肾病患者左心室及右心室Tei指数在评价心室功能方面的临床应用价值。方法将189例患者分成健康对照组60例、慢性肾功能衰竭中非糖尿病肾病组69例及糖尿病肾病组60例,分别测量3组左、右心室常规超声心动图参数,并应用TDI技术测算左、右心室Tei指数并进行比较研究。结果慢性肾功能衰竭患者非糖尿病肾病组患者左、右心室的Tei指数分别为0.45±0.11,0.36±0.10;糖尿病肾病组患者左、右心室Tei指数分别为0.48±0.11,0.40±0.09;健康对照组的Tei指数分别为0.43±0.08,0.33±0.09,3组中非糖尿病肾病组和糖尿病肾病组患者分别与健康对照组Tei指数比较差异有统计学意义(Tei左心室:t1=1.994,t2=2.109,Tei右心室:t1=1.292、t2=2.414,P均<0.05),且糖尿病肾病组患者的Tei指数较非糖尿病肾病组患者显著增大(Tei左心室:t3=2.277,Tei右心室:t3=2.364,P均<0.05),临床表现为舒张功能障碍。结论采用TDI技术测量Tei指数更加简便、敏感且能有效和综合评价糖尿病肾病患者左、右心室功能障碍。对其心室整体功能的评价是一个较好的指标。

Objective To evaluate the ventricular function in patients with diabetic nephropathy by tissue Doppler imaging(TDI) with left and right ventricular Tei index.Methods A total of 60 patients with diabetic nephropathy(DN),69 patients with non-diabetic nephropathy and 60 healthy subjects were studied.The common ultrasonic indices in all subjects were measured and TDI-Tei index of ventricular was calculated.Results Compared with the healthy group,the left and right ventricular Tei index increased in all patients with nephropathy(the left ventricular Tei index:0.45±0.11,0.48±0.11,0.43±0.08,t1=1.994、t2=2.109,the right ventricular Tei index:0.36±0.10,0.40±0.09,0.33±0.09,t1=1.292、t2=2.414,all P<0.05).The Tei index in patients with DN significantly increased compared with that in patients with non-diabetic nephropathy(the left ventricular Tei index:t3=2.277,the right ventricular Tei index:t3=2.364,all P<0.05),and the diastolic function was damaged obviously.Conclusion The ventricular Tei index measured by TDI can be served as a simple,sensitive and comprehensive index in evaluating the left and the right ventricular function of patients with DN.