超声心动图对无明显症状的2型糖尿病患者早期左心室功能减退的评估

Evaluation by ultrasonic cardiogram for early impaired left ventricular function in type 2 diabetes mellitus patients without obvious symptom

目的探讨超声心动图对射血分数(EF)正常的2型糖尿病患者左心室(左室)功能减退检测效果,并评估其影响因素。方法 286例无心脏病史的2型糖尿病患者,利用压力校正左室中段短轴缩短率(sc-MS)和二尖瓣环收缩期峰值速度(S')来评价左室收缩功能。以二尖瓣口舒张早、晚期峰值流速(E、A)、组织多普勒(TDI)测量二尖瓣环舒张期峰值速度(E')及肺静脉频谱形态来评价左室舒张功能,分析各临床参数及超声心动图测量参数与左室功能减退的关系。结果共检出左室功能减退者194例,其中77例是单纯收缩功能减退,45例是单纯的舒张功能障碍,72例舒张及收缩功能减退。结论应用合适的超声心动图指标,可以早期检测无明显症状的2型糖尿病患者是否合并左室功能减退。

Objective To investigate detection effect by ultrasonic cardiogram forimpaired left ventricular function in type 2 diabetes mellitus patientswith normal ejection fraction（EF）, and to evaluate its influencing factors. Methods Left ventricular systolic function in 286 type 2 diabetes mellitus patients without heart disease history were evaluated by pressure correctingleft ventricularmiddle shortening fraction（sc-MS） and mitral ringpeak systolic velocity（S＇）. Mitral ringpeak diastolic velocity（E＇） was detect by peak earlyand late diastolic velocity（E, A） and tissue Doppler imaging（TDI）. Left ventricular diastolic function was evaluated by pulmonary vein spectrum morphology. Relationship between clinical parameters, ultrasonic cardiogram data and impaired left ventricular function was analyzed. Results Among all 194 cases with detectedimpaired left ventricular function, there were 77 cases with single systolic function impairment, 45 cases with single diastolicfunction impairment and 72 cases with systolic and diastolic function impairment. Conclusion Rational implement of ultrasonic cardiogram index can provide early detection for impaired left ventricular function in type 2 diabetes mellitus patients without obvious symptom.