SPECT心肌灌注显像和超声心动图对糖尿病性心肌病心功能的评估价值

The role of SPECT myocardial perfusion imaging and echocardiography in assessing cardiac function of patients with diabetic cardiomyopathy

目的研究单光子发射计算机断层(SPECT)心肌灌注显像和二维超声心动图(2DE)对糖尿病性心肌病(DCM)心功能的评估价值。方法使用SPECT心肌灌注显像与2DE对56例DCM患者分别进行左心室容积及功能检查,其中纽约心脏病学会(NYHA)心功能分级Ⅰ～Ⅱ级21例,Ⅲ级17例,Ⅳ级18例。SPECT心肌灌注显像采用QGS软件处理,2DE采用Simpson法测算。结果两种检查方法的舒张末期容量(EDV)、收缩末期容量(ESV)和射血分数(EF)值差异均有统计学意义(P<0.05),对三项指标测值的相关性较好(r值分别为0.892、0.732、0.856,P<0.01),两种检查方法均显示心功能Ⅲ、Ⅳ级EDV、ESV和EF值与心功能Ⅰ～Ⅱ级者差异有统计学意义(P<0.01)。结论 SPECT心肌灌注显像能较好的评估心功能指标,2DE低估了左心室容积;两种检查方法均能较好的反映NYHA心功能分级。

Objective To study the significance of single photon emission computed tomography（SPECT） myocardial perfusion imaging and two-dimensional echocardiography（2DE） in assessing cardiac function of patients with diabetic cardiomyopathy（DCM）.Methods SPECT myocardial perfusion imaging and 2DE were performed in 56 patients with diabetic cardiomyopathy,who were NYHA class Ⅰ-Ⅱin 21 cases,class Ⅲ in 17 cases and class Ⅳ in 18 cases.Left ventricular（LV） volumes and function were measured using QGS software for SPECT myocardial perfusion imaging and Simpson＇s method for 2DE.Results There was a significant difference between SPECT myocardial perfusion imaging and 2DE in the estimation of end diastolic volume （EDV）,end systolic volume（ESV） and ejection fraction（EF）（P0.05）.The correlation between SPECT myocardial perfusion imaging and 2DE was good for the assessment of EDV,ESV and EF（r=0.892,0.732,0.856,respectively,P0.01）.EDV,ESV and EF were significantly different among NYHA class Ⅲ,Ⅳ and Ⅰ-Ⅱ graded by two methods（P0.01）.Conclusion SPECT myocardial perfusion imaging is good for the assessment of LV volumes and function,while 2DE underestimates LV volumes.The test results of two methods both better reflect the NYHA functional classification.