多普勒Tei指数测定对2型糖尿病早期心肌损害的价值

Assessment of early myocardial damage in patients with type 2 diabetes mellitus using Tei index by pulse wave Doppler and tissue Doppler imaging

目的探讨多普勒Tei指数测定在评价2型糖尿病患者早期心肌损害方面的价值,并对组织多普勒(TDI)与脉冲多普勒(PW)测得的Tei指数进行比较。方法 43例2型糖尿病患者根据伴或不伴微血管病变分为2组,并设健康对照组40例。分别测EF值、E/A,同时用PW及TDI测Tei指数。结果传统的心脏收缩功能指标EF值、舒张功能指标E/A比值3组之间差异均无统计学意义(P均>0.05)。糖尿病不伴微血管病变组PW-Tei指数与对照组比较差异无统计学意义〔(0.51±0.05)vs(0.42±0.07),P>0.05〕,而TDI-Tei指数与对照组比较差异有统计学意义〔(0.62±0.06)vs(0.45±0.03),P<0.05〕。在糖尿病伴微血管病变组,两种测得的Tei指数与对照组比较差异均有统计学意义〔(0.63±0.07)vs(0.42±0.07),P<0.05);(0.69±0.07)vs(0.45±0.03),P<0.05〕。结论 2型糖尿病患者在传统超声未发现心脏异常时,Tei指数已出现异常,且TDI-Tei指数较PW-Tei指数更敏感。

Objective To explore the value of Tei index in assessing early myocardial damage of patients with type 2 diabetes mellitus,and compare the Tei indexes measured by pulse wave Doppler and tissue Doppler imaging.Methods All 43 patients with type 2 diabetes mellitus were divided into two groups according to with or without microangiopathy（n=21,n=22 respectively）,and 40 healthy volunteers were served as control group.Ejection fraction （EF） and the ratio of E peak and A peak of mitral valve flow （E/A） in three group were measured and compared,and the Tei indexes were obtained by pulse wave Doppler （PW-Tei） and tissue Doppler imaging （TDI-Tei）,respectively.Results The EF and E/A had no significant difference in three group （all P0.05）.Compared with the control group,PW-Tei indexes had no significant difference 〔0.51±0.05） vs （0.42±0.07）,P0.05〕,and TDI-Tei indexes were statistically different 〔（0.62±0.06） vs （0.45±0.03）,P0.05〕 in type 2 diabetes mellitus without microangiopathy group;PW-Tei indexes and TDI-Tei indexes had all significant difference in type 2 diabetes mellitus with microangiopathy group〔（0.63±0.07） vs （0.42±0.07）,（0.69±0.07） vs （0.45±0.03）,all P0.05〕.There was a positive correlation between TDI-Tei index and PW-Tei index（r=0.53,P0.05）.Conclusions The Tei index has clinical value in assessing the early myocardial damage of patients with type 2 diabetes mellitus,and the TDI-Tei index may be more sensitive than PW-Tei index.