多普勒超声心动图充盈分数法评价糖尿病性心肌病左室舒张

Evaluation of Filling Fraction Methods to Diabetes Patients with Left Ventricular Diastolic by Doppler Echocardiography

目的评价非胰岛素依赖型糖尿病(NIDDM)左室舒张功能改变的临床意义,为临床NIDDM心肌舒张功能的改善及糖尿病性心肌病的筛选与治疗提供依据。方法选择60例NIDDM患者,分为全组、伴心血管合并症组及无心血管合并症组。应用多普勒超声心动图检测左室舒张期血流速度积分(FVI)及1/3、1/2充盈分数(1/3FF、1/2FF)并与30例健康查体者进行对比分析。结果NIDDM全组FVI减低,但无显著性差异(P>0.05);1/3FF相差非常显著(P<0.01);1/2FF相差显著(P<0.05)。NIDDM伴合并症组FVI、1/2FF相差显著;1/3FF相差非常显著(P<0.01)。无合并症组1/3FF相差显著,FVI、1/2FF无显著性差异。结论NIDDM伴合并症组心肌舒张功能严重受损,应视为糖尿病性心肌病,无合并症组仅早期舒张功能减退,心肌代偿性好,可视为临床前期心肌损害。多普勒超声心动图充盈分数法是评价NIDDM患者左室功能的敏感指标,并可用于糖尿病性心肌病的筛选。

Objective To evaluate the significance of left ventricular（LV） diastolic function in patients with non-insulin dependent Diabetes Mellitus （NIDDM）, and to provide some evidence about the improvement of ventricular myocardium function and the screen and the treatment of NIDDM for clinic. Methods 60 patients with NIDDM were enrolled into three groups（all the NIDDM patients, NIDDM with cardiovascular complication, NIDDM without complication）. Left ventricular diastolic FVI, 1/2 FF and 1/3 FF were measured by Doppler echocardiography. 30 healthy volunteers were taken as the control group. Results FVI of the all NIDDM group was lower than the control group, but there was not obvious significant between of the two groups （P〉0.05）,while there was significant difference in 1/2 FF （P〈0.05） and markedly significant difference in 1/3 FF （P〈0.01）. To NIDDM with complication group, significant difference was found in FVI and 1/2FF （P〈0.05） and markedly significant difference was found in 1/3 FF （P〈0.01）. There was significant difference in FVI and 1/2 FF （P〈0.05） and markedly significant difference in 1/3 FF （P〈0.01） between NIDDM without complication and control group. Conclusion NIDDM group with cardiovascular complication has severe cardiac muscular impairment and can be regarded as diabetes cardiomyopathy. NIDDM without complication group only has catty decreased positive diastolic function but has good compensatory myocardium and can be regarded as subclinical cardiac muscular injury.Filling fraction methods by echocardiography can be used to evaluate LV diastolic function in patients with diabetes to screen diabetes echocardiography.