Tei指数评估无症状糖尿病患者左心功能的探讨

The study of Tei index for the evaluation of left ventricular function in patients with diabetes mellitus

目的应用Tei指数研究糖尿病对左心室心功能的影响,探讨其在评价糖尿病患者心功能中的应用价值。方法受试人群分为糖尿病组(DM,n=36)及正常对照组(NM,n=33)。应用改良Simpson公式,测定左室射血分数(EF)。利用TDI测量心尖四腔、心尖两腔、心尖长轴切面二尖瓣环六位点及右室基底部收缩期运动峰速(Sm)、舒张期早期运动速度(Em)、舒张期晚期运动速度(Am)、计算Em/Am及Tei指数。然后比较心功能指标的差异及各参数间的相关关系。结果左室Tei指数组间比较统计学差异明显,平均Sm、平均Em/Am均与Tei指数成负相关,Tei指数预测糖尿病患者舒张功能不全AUC=0.761±0.103,P<0.01,敏感性为63.6%,特异性为95.2%。结论糖尿病患者存在左室舒张功能不全,可能存在收缩功能不全,Tei指数可用于评估早期糖尿病患者的左心功能。

Objective To study the influence of diabetes mellitus（DM） on left ventricular function by using Tei index,and to explore the value of Tei index for the evaluation of heart function in DM patients.Methods The participants were divided into DM groups（n=36） and control group（n=33）.Left ventricular eject faction（EF） was assessed by improved Simpson formula.Conventional left ventricular diastolic function parameters were acquired by pulsed Doppler.The mitral annular peak systolic（Sm） and early diastolic（Em） and peak late（Am） velocities were determined by Color TDI in the apical views（4-and 2-chamber,and long-axis）,the Em/Am and Tei index were calculated.Then the function parameters of the DM group were compared with the control group,and the difference of the cardiac function and the correlation of the parameters were analyzed.Results There were difference of the Tei index between the three groups.Negative correlation were found between Sm and Tei index,and so as between the E/Em.And the Tei index.The AUC of the Tei index for the prediction of diastolic function in patients with DM was 0.761±0.103,the sensitivity was 63.6% and specificity was 95.2%（P0.01）.Conclusion There are diastolic dysfunction and maybe systolic dysfunction in patients with DM;and Tei index may be useful in the prediction of earlyleft ventricle function in patients with DM.