冠脉血流显像技术评价2型糖尿病的心功能和冠脉血流储备

Evaluation of Coronary Flow Reserve and Left Ventricular Function by Coronary Flow Imaging in Patients with Type 2 Diabetes

目的:利用超声心动图冠脉血流显像技术检测2型糖尿病早期心功能的改变,并计算和评价其冠脉血流储备(CFR)。方法:测量20例正常对照组、50例2型糖尿病患者的超声心动图,检查心脏结构、功能、左冠脉前降支冠脉血流舒张期峰值血流速度(PDV)、血流速度时间积分(PDVTI),经静脉注射腺苷140μg(/kg.min)后达最大充血状态时的左冠脉前降支舒张期峰值血流速度(PDVa)、血流速度时间积分(PDVTIa)、计算CFR。空腹取血测血糖、血脂。结果:左室收缩功能损害较轻,舒张功能明显减退,糖尿病者左心房内径增大,左室壁增厚,CFR下降,血糖升高(P<0.01)。结论:利用冠脉血流显像技术依据静脉注射腺苷后冠脉血流速度的变化计算CFR,该方法简单易行,价廉并且准确可行,可很好评价2型糖尿病冠脉微循环。

Objective：To evaluate the coronary flow reserve（CFR）and early changes of left ventricular function in type 2 diabetes mellitus（DM）by coronary flow imaging technique.Methods：Echocardiography was done in 50 patients with DM and 20 health controls to measure the heart size,left ventricular function,the ratio of peak diastolic velocity（PDV）and peak diastolic velocity integrate（PDVTI）.The PDV and PDVTI in left anterior descending coronary artery were also measured after intravenous administration of adenosine 140 g/（kg·min）.The blood glucose and lipid were detected.Results：The left ventricular systolic dysfunction,left atrium enlargement and hypertrophy of left ventricle were found in DM patients.The coronary flow reserve（CFR）was decreased.The blood glucose in DM patients increased compared with that of control（P 〈 0.01）.Conclusion：The evaluation of CFR by coronary flow imaging is a useful method to estimate coronary microcirculation function.