脉冲组织多普勒成像技术检测糖尿病患者左室舒张功能

Detection of the left ventricular diastolic function in diabetes mellitus using pulsed wave tissue Doppler imaging

目的应用脉冲组织多普勒成像技术(PWDTI)检测糖尿病(DM)组和健康对照组左室舒张功能,并与传统二尖瓣血流频谱E/A比较。方法用PWDTI在心尖左室长轴水平二尖瓣环后壁处测量舒张期E峰速度(Ve)、A峰速度(Va),计算Ve/Va比值;在同一切面用彩色多普勒血流显像技术(CDFI)测量二尖瓣口舒张期血流频谱E峰、A峰值,计算E/A比值,并计算E/Ve比值。DM组根据尿蛋白阴性或阳性分为两亚组,并根据糖化血红蛋白(HbA1c)浓度≤或>7%分为两亚组。结果DM组和健康对照组Ve/Va比值[(0.87±0.37)、(1.21±0.4)]以及E/Ve比值[(9.24±4.47)、(6.03±1.72)]差异有统计学意义(P<0.05)。DM组尿蛋白阴性、阳性亚组的E/Ve比值分别为(7.36±2.46)、(10.5±2.49),DM组HbA1c≤7%和>7%亚组E/A比值分别为(0.64±0.24)、(1.32±0.22),两亚组比较均差异有统计学意义(P<0.05)。结论PWDTI观测DM左室舒张功能较传统二尖瓣口血流频谱E/A具有明显的优越性,两者结合起来能更好地反映左室舒张功能。

Objective:To detect the left ventricular diastolic function in diabetes mellitus (DM) using pulsed wave Doppler tissue imaging (PW-DTI) and comparing with tranditional transmitral inflow velocity E/A. Method:Early diastolic velocity (Ve) and late diastolic velocity (Va) of posterior mitral annulus were measured from apical long-axis views using PW-DTI and calculated Ve/Va. From the same apical long-axis views, transmitral inflow velocity E and A were obtained using color Doppler flowing imaging (CDFI) , then calculated E/A and E/Ve ratio. The DM group were divided into two subgroup: one with microalbuminuria and one without microalbuminuria . The DM group were also divided into another two subgroup according to the hemoglobin A1c level (Hb A1c%). Result:The ratio Ve/Va between DM group and normal group are 0.87±0.37,1.21±0.4 and the ratio E/Ve between them are 9.24±4.47,6.03±1.72 ( P < 0.05 ). The ratio E/Ve between the sub group with microalbuminuria and the subgroup without microalbuminuria are 7.36±2.46,10.5±2.49 and the ratio E/A between HbA1c <7% group and HbA1c>7% group are 0.64±0.24,1.32±0.22 ( P < 0.05 ) too. Conclusion:PW-DTI is superior to transmitral inflow velocity E/A ratio in detecting the left ventricular diastolic function in diabetes mellitus. It will be better if they are used together.