超声二尖瓣环位移追踪技术在2型糖尿病病人左心室功能评价中的应用

Application value of ultrasound tracking of mitral annular displacement in evaluating the left ventricular function in patient with type 2 diabetes mellitus

目的:探讨二尖瓣环位移追踪(tracking of mitral annular displacement,TMAD)技术对2型糖尿病(T2DM)病人左心室功能的评价价值。方法:选取T2DM病人27例,按照就诊时间及年龄、性别、体质量、身高匹配健康志愿者27名。应用超声诊断仪测量常规参数,并连续获得3个心动周期高质量的心尖四腔心、心尖两腔心二维图像,打开TMAD软件,在机测量二尖瓣环4个位点的收缩期峰值位移(Ds)、瓣环连线中点最大位移(Mid)、Mid与左心室舒张期末最大纵径比值(Mid%),并计算均值。应用实时三维超声心动图测量左心室射血分数(LVEF),并将TMAD测量参数(Ds、Mid、Mid%)与二维、三维LVEF进行相关性分析。结果:2组E峰/A峰及E/A比值、左心室舒张末期容积、守缩末期容积、LVEF等常规参数差异均无统计学差异(P>0.05)。T2DM组各位点Ds、Mid、Mid%及其均值均低于对照组(P<0.05~P<0.01)。所有受试者Ds、Mid、Mid%均值均与二维(r=0.349、0.367、0.350,P<0.05)、三维(r=0.449、0.487、0.386,P<0.05)测量LVEF呈正相关关系。结论:TMAD技术能够无创评价T2DM病人左心室功能。

Objective： To evaluate the application value of ultrasound tracking of mitral annular displacement（ TMAD） in evaluating the left ventricular function in patient with type 2 diabetes mellitus（ T2 DM）. Methods： Twenty-seven T2 DM patients and 27 healthy volunteers were investigated. The high quantity two dimensional gray scale imaging of three consecutive cardiac cycles was obtained using the echocardiography. The systolic peak displacement（ Ds）,maximum displacement of the midpoint of the annulus（ Mid） and maximum longitudinal diameter ratio of left ventricular end diastolic diameter（ Mid%） at 4 sites of mitral annulus were measured using TMAD software,and the means value of which was calculated. The LVEF was measured using real time three dimensional echocardiography,and the correlation of the parameters of TMDA（ Ds,Mid and Mid%） with two/three-dimensional？ image LVEF were analyzed. Results： The differences of the E peak/A peak,ratio of E/A,left ventricular end-diastolic volume,end-systolic volume and LVEF between two groups were not statistically significant（ P〉0. 05）. The Ds,Mid and Mid% value in T2 DM group were lower than those in control group（ P〈0. 05 to P〈0. 01）. The means value of Ds,Mid and Mid% in two groups were positive correlation with two/three-dimensional LVEF（ P〈0. 05） Conclusions： TMAD） technique can be used to evaluate the left ventricular function in patients with T2 DM.