2型糖尿病患者左室整体舒缩功能与HbA1c的相关性研究

Study on the Relationship of Global Left Ventricular Systolic and Diastolic Function with HbAlc in Patients with Type 2 Diabetes Mellitus

【目的】应用实时三平面定量组织速度成像技术（Triplane‐QTVI）评价2型糖尿病（T2DM）患者左室功能，并探讨T2DM患者左室功能与糖化血红蛋白（HbA1c）的相关性。【方法】选取单纯T2DM患者50例（T2DM组）和正常体检者50例（对照组），采用常规超声心动图、Triplane‐QTVI技术检测左室纵轴收缩、舒张功能；检测T2DM患者的HbA1c ，并探讨超声心动图参数与 HbA1c的相关性。【结果】两组左室射血分数（EF％）、左室短轴缩短率（FS％）、二尖瓣环收缩期均值速度（Sm ）及二尖瓣口舒张早期最大血流速率（E ）比较无统计学意义（ P ＞0．05）；T2DM组左房收缩期最大血流速率（A）、二尖瓣环舒张晚期均值速度（Am）、E／二尖瓣环舒张早期均值速度（Em）高于对照组，E／A、Em、Em／Am明显低于对照组（ P ＜0．01）。HbA1c与E／A呈线形负相关（ P ＜0．05），与E／Em呈线形正相关（ P＜0．05），与EF、FS、E、A、Sm、Am不相关性。【结论】Triplane‐QTVI能够准确评价T2DM患者左室纵轴收缩、舒张功能，T2DM患者左室舒张功能障碍早于收缩功能，HbA1c与左室舒张功能障碍相关。

[Objective]To evaluate left ventricular（LV） systolic and diastolic function of patients with type 2 diabetes mellitus（T2DM） by using real‐time triplane quantitative tissue velocity imaging （Triplane‐QTVI） ,and to explore the relationship between LV function and hemoglobin A1c（HbA1c） in patients with T2DM .[Methods]Totally 50 T2DM patients（T2DM group） and 50 normal health examination persons（control group） were chosen . LV longitudinal axis systolic and diastolic function was detected by using conventional echocardiography and Tri‐plane‐QTVI .The HbA1c in patients with T2DM patients was determined .The correlation between echocardio‐gram parameters and HbA1c was discussed .[Results]There was no significant difference in LV ejection fraction （EF% ） ,LV minor axis decurtaion rate（FS% ） ,mean velocity of systolic mitral ring （SM ） and maximum flow ve‐locity of early diastolic mitral orifice（E） between two groups（ P 〉0 .05） .Maximum flow velocity of systolic LV （A ） ,mean velocity of late diastolic mitral ring （Am ） and E/mean velocity of early diastolic mitral ring （Em ） in T2DM group were higher than those in control group ,while E/A ,Em and Em/Am were obviously lower than those in control group（ P〈0 .01） .HbA1c had negative linear correlation with E/A（ P〈0 .05） ,and positive line‐ar correlation with E/Em（ P 〈0 .05） ,and no correlation with EF ,FS ,A ,Sm and Am .[Conclusion]Triplane‐QTVI can accurately evaluate LV longitudinal axis systolic and diastolic function .LV diastolic dysfunction in pa‐tients with T2DM is earlier than systolic dysfunction .HbA1c is associated with LV diastolic dysfunction .