摘要
目的 探讨定量组织多普勒技术 (QTVI)技术评价糖尿病 (DM)患者左室心肌收缩与舒张功能的价值。方法 应用 QTVI获取 35例正常人和 4 8例 DM患者左室长轴方向不同室壁节段即左室前壁、后壁、下壁、侧壁及室间隔的心肌多普勒速度曲线 ,分别比较以下参数 :1.不同室壁中部心肌运动收缩期峰值速度 (Vs)、快速充盈期和心房收缩期的速度 (Ve和 Va) ;2 .二尖瓣舒张期血流频谱 E/ A值、左室射血分数 (L VEF)、 L VMI(左室质量指数 )、 Vs/ Ve比值。结果 (1) DM患者 Vs、 Ve、 Va、 Vs/ Ve、 L VEF均比正常人降低 (P<0 .0 5 ) ;(2 )若以 Vs>4 .5 cm/ s、Vs/ Ve>0 .80、L VEF>4 5 %作为判定患者心功能符合临床 NYHA分级 ～ 级、客观评分 A～ B级的界定值 ,其敏感性 80 % ,特异性 85 % ,阳性预测值 86 % ;(3) DM患者 Vs的测值越低 ,临床 NYHA分级越差 ,它们之间有一定的负相关性 (r=- 0 .75 )。结论 QTVI定量评价 DM患者左室心肌功能 ,为进一步了解 DM局部心肌收缩舒张功能变化及其局部与整体心肌功能的变化提供较为敏感、精确的方法。
Objective This study was designed to assess the left ventrlcular(LV) regional systolic and diastolic function,left ventricular wall motion features in patients with diabetes mellitus (DM) using qantitative tissue veloclty imaging.Methods A total of 35 normal subjects and 48 DM patients underwent QTVI study.Off-line LV regional velocity imaging and displacement profiles along LV apical long-axis view were obtained synchronously。Peak tissue velocities of LV regional muscular tissue during systole(Vs),early diastole(Ve),LA contraction(Va),LV ejection fraction (LVEF),mitral valve peak flow velocity E/A ratio,left ventricular mass index(LVMI) were measured and compared with normal subjects and DM patients.Results ①Vs,Va,Ve, Vs/Ve, LVMI,LVEF were significantly reduced and LVMI were higher in DM patients than those in normal subjects ②Vs > 4.5 cm/s,Vs/Ve>0.80,LVEF>45% can be used to evaluate the earlier LV function (NYHA classⅠ-Ⅱ).Objective evaluating class A-B, in DM patients with higher sensitivity of 80%,specificity of 85%,and positive predictive value of 86%.③The less Vs,the worse of NYHA class in DM patients,and there was a significant negative relationship between Vs and NYHA class(r=-0.75).Conclusions QTVI offers a newer method in clinical practice which has a higher sensitivity and accuracy in evaluating the LV regional systolic and diastolic function in DM patients.
出处
《中国超声诊断杂志》
2004年第12期907-910,共4页
Chinese Journal of Ultrasound Diagnosis
