左室舒张功能不全2型糖尿病肾病患者超声心动图与NT-proBNP检测结果分析

Analysis of the results of echocardiogram and NT-proBNP in patients with type 2 diabetic nephropathy and left ventricular diastolic dysfunction

目的探讨左室舒张功能不全2型糖尿病肾病患者超声心动图检测结果与B型脑钠肽前体水平的相关性。方法对90例2型糖尿病肾病患者进行超声心动图检查,测量患者左心室相关指标,根据舒张早期二尖瓣口血流速度和舒张晚期二尖瓣血流速度比值将2型糖尿病肾病患者分为左室舒张功能正常组和左室舒张功能不全组,比较两组超声心动图相关参数及血清B型脑钠肽前体水平,并进行相关性分析。结果入组90例患者中左室舒张功能不全48例,左室舒张功能正常42例。左室舒张功能不全组血清B型脑钠肽前体水平显著高于左室舒张功能正常组(P<0.01),舒张末期室间隔厚度、左心室后壁厚度显著大于左室舒张功能正常组(P<0.01),舒张早期二尖瓣口血流速度/舒张晚期二尖瓣血流速度、舒张早期二尖瓣口血流速度/舒张早期二尖瓣环运动速度显著小于左室舒张功能正常组(P<0.01)。相关性分析显示,血清B型脑钠肽水平与舒张末期室间隔厚度、左心室后壁厚度呈显著正相关(P<0.01),与舒张早期二尖瓣口血流速度/舒张晚期二尖瓣血流速度、舒张早期二尖瓣口血流速度/舒张早期二尖瓣环运动呈显著负相关(P<0.01)。结论左室舒张功能不全2型糖尿病肾病患者左室明显增大,血清B型脑钠肽前体水平较高,血清B型脑钠肽前体水平与超声心动图相关参数存在相关性。提示及早监测血清B型脑钠肽前体水平有利于早期评估患者左室舒张功能。

Objective To explore the correlation between the results of echocardiogram and the level of Nterminal pro-brain natriuretic peptide(NT-proBNP) in patients with type 2 diabetic nephropathy(T2DN)and left ventricular diastolic dysfunction.Methods Echocardiogram was performed on 90 patients with T2DN,and related indicators of the left ventricle were measured.According to the early diastolic mitral valve orifice blood flow velocity(E) to advanced diastolic mitral valve blood flow velocity(A) ratio,patients with T2DN were divided into normal left ventricular diastolic function group and left ventricular diastolic dysfunction group.The echocardiogram related parameters and serum NT-proBNP levels were compared between the two groups,and the correlation was analyzed.Results Among the 90 patients enrolled,48 had left ventricular diastolic dysfunction and 42 had normal left ventricular diastolic function.Serum NT-proBNP level of the left ventricular diastolic dysfunction group was significantly higher than that of the normal left ventricular diastolic function group(P<0.01).The end diastolic ventricular septal thickness(IVST) and left ventricular posterior wall thickness(LVPW) of the left ventricular diastolic dysfunction group were significantly larger than those of the normal left ventricular diastolic function group(P <0.01),while E/A and E/early diastolic velocity of the mitral annulus(E’) were significantly smaller than those of the normal left ventricular diastolic function group(P<0.01).Correlation analysis showed that serum NT-proBNP was significantly positively correlated with IVST and LVPW(P<0.01),but was significantly negatively correlated with E/A and E/E’(P<0.01).Conclusions The left ventricle of T2DN patients with left ventricular diastolic dysfunction is significantly enlarged,and the serum NT-proBNP level is higher.There is a correlation between the serum NT-proBNP level and the echocardiogram results.Early monitoring of serum NT-proBNP is conducive to the early assessment of the patient’s left ventricular diastolic function.