超声TVI技术评价冠心病合并糖尿病患者心室舒缩同步性的研究

The Study on the Systolic and Diastolic Ventricular Syn-chronization in Patients with Coronary Heart Disease Complicating Diabetes Mellitus Evaluated by Doppler Tissue Velocity Imaging Technology

目的:应用超声组织速度显像(TVI)技术检测冠心病合并糖尿病患者心肌的同步性运动。方法:59例冠心病患者为对照组,68例冠心病合并糖尿病患者为研究组,超声TVI模式下测量收缩期和舒张早期左、右室基底段和中间段共12节段的收缩(Ts)和舒张达峰(Te)时间,并计算左室12节段舒缩达峰时间的平均值(Ts-12-LV、Te-12-LV)、标准差(Ts-12-SD)和最大差值(Ts-12-diff、Te-12-diff)及右室2节段舒缩达峰时间平均值(Ts-2-RV、Te-2-RV)。结果:研究组左右室12个节段Ts-12-LV、Ts-2-RV及Ts-12-SD与对照组比较差异无统计学意义(P>0.05),以Ts-12-SD>33ms为标准,研究组达此标准者占17例(25.00%),对照组为11例(18.64%);以Ts-12-diff>100ms为标准,研究组和对照组不同步者比例分别为50%(34/68)和28.8%(17/59),差异有统计学意义(P<0.05)。以Te-12-diff>100ms为室内舒张不同步标准,研究组和对照组分别占47.1%和25.4%(P<0.01)。结论:冠心病患者心脏的收缩及舒张同步性减低,糖尿病可使其加重。

Objective： To detect the ventricular synchronization of myocardial motion by Dopler tissue velocity imaging （TVI） technology in coronary heart disease （CHD） patients with diabetes mellitus （DM）. Methods： Fifty-nine patients with CI-[D were included in the control group, and 68 patients with CHD and DM were the study group, The time to peak velocity at systolic and early diastolic phase （Ts and Te） in the base and interlude altogether 14 segments of left and right ventricular were measured in all subjects. The average time of Ts and Te in left ventricular 12 segments （Ts-12-LV and Te-12-LV）, the 12 segments standard deviation of Ts （Ts-12-SD）, the 12 segmental maximal Ts and Te difference （Ts-12-diff and Te-12-diff） and the average time of Ts and Te in right ventricular 2 segments （Ts-2-RV and Te-2-RV） were calculated and compared between groups. Results： There were no significant differences in Ts of 11 segments of left ventricular, Ts-12-LV, Ts-2-RV, Ts-2-RV and Ts-12-SD between the two groups（P 〉 0.05）. Using the Ts-12-SD〉33 ms as the standard, there were 17 patients achieved this standard in the study group （25.00%）, 11 cases in control group （18.64%）. Using Ts-12-diff〉 100 ms as the standard, the ratio of the two groups were 50% （34/68） and 28.8% （17/59, P 〈 0.01）. The Te-12-diff was failed to demonstrate any significant differences between the two group（P 〉 0.05）, but under the standard of Te-12-diff〉100 ms, the two groups accounted for 47.1% and 25.4% （P 〈 0.01）. Conclusion： The systolic and diastolic synchronization was re- duced in patients with CHD, which can be aggravated by DM. Key words laser-doppler flowmetry coronary disease diabetes mellitus exercise test constriction ventricular function