定量组织速度显像技术评价单纯糖尿病患者左室舒张功能的研究

Quantitative tissue velocity imaging for left ventricular diastolic function in simplex diabetic patients

目的使用定量组织速度显像(QTVI)技术对单纯糖尿病患者左室舒张功能进行评价,并与传统检测舒张功能的方法进行比较,寻找更敏感的检测手段。方法入选单纯糖尿病患者31例,与健康人24例进行对照。使用GE公司Vivid 7彩色超声诊断仪,经胸获取胸骨旁长轴切面、心尖四腔切面、心尖两腔切面和心尖长轴切面,在相应切面分别记录经二尖瓣血流频谱舒张早期充盈峰值速度(E),舒张晚期充盈峰值速度(A)及E峰减速时间(EDT);右上肺静脉血流频谱收缩期峰值流速(S波),舒张早期峰值流速(D波),心房收缩期负向波峰值流速(AR);使用QTVI技术测量左室侧壁、后间隔、左室前壁、下壁及左室后壁及前间隔二尖瓣环舒张早期峰值速度(Ea),舒张晚期峰值速度(Aa)和Ea/Aa。结果二尖瓣口血流多普勒频谱E/A比值、EDT、肺静脉血流频谱S/D比值在两组之间差异均无统计学意义;肺静脉血流频谱的AR在糖尿病组明显增大[(0.3±0.07)m/svs(0.22±0.03)m/s,P<0.01]。二尖瓣环6个节段的Ea平均值在两组之间差异无统计学意义,但糖尿病组Aa的平均值明显升高[(7.03±1.33)cm/svs(5.27±0.89)cm/s,P<0.01],各节段Ea/Aa比值的平均值显著降低[(1.11±0.38)vs(1.56±0.64),P<0.01]。结论QTVI技术在检测糖尿病心肌病左室舒张功能方面更加敏感。

Objective To evaluate the left ventricular diastolic function of simplex diabetic patients by quantitative tissue velocity imaging （QTVI） and compare with the traditional echocardiographic index in order to find a sensor way. Methods Thirty-one simplex diabetic patients were compared with 24 age-matched healthy individuals. Vivid 7 equipment of GE company was used. Transmitral blood Doppler velocity profile and right upper pulmonary vein Doppler velocity profile were acquired in apical four-chamber views and transmitral peak velocity of E wave（E）, A wave（A）, E wave decelerate time（EDT）, and right upper pulmonary vein peak systolic velocity（S）, early diastolic peak velocity（D） and negative wave（AR） were measured. QTVI technique was used to measure the early diastolic （Ea）, late diastolic velocities （Aa） and Ea/Aa ratio of mitral annuli in left lateral wall, left anterior wall, left inferior wall, left posterior wall, anterior septum and posterior septum in different sections. Results The difference of E/A, EDT, S/D between the two groups has no statistical significance. AR is significant greater in diabetic group [（0.34± 0.07） m/s vs （0. 22±0.03） m/s, P 〈0. 01]. The average Ea value of six points in mitral annuli has no significant difference between the two groups. But in diabetic group the average Aa value increased significantly [（7.03±1.33） cm/s vs （5.27 ±0.89） cm/s, P〈 0. 01], and the average Ea/Aa ratio decreased significantly [（1.11 ± 0. 38） vs （1.56±0.64）, P 〈0. 01]. Conclusion QTVI technique is a more sensor way to asses left ventricular diastolic function of diabetic cardiomyopathy.