2型糖尿病患者左心室结构和功能的磁共振研究及其与临床资料的相关性

Magnetic Resonance Study of Left Ventricular Structure and Function in Patients with Type 2 Diabetes Mellitus and Its Correlation with Clinical Data

目的:采用心脏磁共振(CMR)定量评价2型糖尿病(T2DM)患者左心室结构和功能,探讨其与临床资料的相关性。方法:对23名T2DM患者(T2DM组)和22名健康志愿者(对照组)进行CMR扫描,分析2组在临床资料、左心室结构功能指标间的差异,并对T2DM组左心室结构功能指标与临床资料进行相关性分析。结果:与对照组比较,T2DM组总胆固醇、甘油三酯、载脂蛋白B、游离脂肪酸升高,左心室舒张末期和收缩末期内径扩大,左心室心尖水平下壁变薄,左心室收缩末期容积(ESV)和收缩末期容积指数(ESVI)增加,射血分数(EF)、每搏输出量指数(SVI)、心脏指数(CI)、高峰充盈率/舒张末期容积(PFR/EDV)减低。上述指标的组间差异具有统计学意义(P<0.05)。T2DM组病程与左心室舒张末期容积呈负相关,载脂蛋白B与左心室心尖水平下壁厚度呈负相关,左心室收缩末期内径与性别有显著相关性。结论:T2DM会造成患者左心室功能减低、内径扩大、心尖水平下壁变薄。病程增加是左心室收缩功能减低的影响因素之一。载脂蛋白B升高可引起左心室室壁厚度变薄。

Purpose:To evaluate left ventricular structure and function in patients with type 2 diabetes mellitus(T2 DM)by cardiac magnetic resonance imaging(CMR)and analyze its correlation with clinical data.Methods:A total of 23 patients with T2 DM(T2 DM group)and 22 healthy volunteers(control group)were examined by CMR.The differences in clinical data and left ventricular structure and function indexes between the two groups were analyzed,and the correlation between left ventricular structure and function indexes and clinical data in T2 DM group was analyzed.Results:Compared with the control group,the patients in T2 DM group were shown with the increase of total cholesterol,triglyceride,apolipoprotein B and free fatty acid,and with dilation of left ventricular end diastolic dimension and end systolic dimension,thinning of left ventricular inferior wall at apical level,increase of left ventricular end systolic volume(ESV)and end systole volume index(ESVI),and decrease of eject fraction(EF),stroke volume index(SVI),cardiac index(CI),peak filling rate/end diastole volume(PFR/EDV).The differences of the above indexes between two groups were with statistical significance(P<0.05).In T2 DM group,the course of the disease was negatively correlated with left ventricular end systolic volume,the level of apolipoprotein B was negatively correlated with left ventricular inferior wall at apical level,left ventricular end systolic dimension was significantly correlated with gender.Conclusions:T2 DM can result in decreased left ventricular function,enlargement of left ventricular diameter and thinning of the apical horizontal inferior wall.The increased disease course is one of the factors affecting the decrease of left ventricular systolic function.The increase of apolipoprotein B can cause the thinning of left ventricular wall.