CAJ | 학술논문

目的应用超声技术研究Ⅱ型糖尿病患者心脏-血管耦联.方法 Ⅱ型糖尿病患者80例,分为射血分数(EF)正常组(DMN组,EF≥50％)40例,EF减低组(DMA组,EF＜50％)40例；健康志愿者42例作为对照组.测量左心室相对室壁厚度(RWT)、质量指数(LVMI)、每搏量(SV),计算每搏功(SW)、心率血压乘积(RPP)、循环血管阻力指数(SVRI)、左心室收缩末期弹性(Ees)、有效动脉弹性(Ea)和心脏-血管耦联指数(VVI).获取左心室基底(LSBA)、乳头肌(LSPM)和心尖水平的纵向应变(LSAP).结果 ①与对照组比较,DMN组RWT、LVMI增加(P＜0.01),LSBA、LSPM及LSAP减低(P＜0.01).DMA组RWT减低(P＜0.01),LSBA、LSPM及LSAP均减低(P＜0.01).DMA组LSBA、LSPM及LSAP明显低于DMN组(P＜0.01).②与对照组比较,DMA组Ea、VVI、RPP及SVRI增高,Ees减低(P＜0.05),DMN组RPP增高(P＜0.01).DMA组Ea、VVI、RPP、SVRI高于DMN组,Ees低于DMN组(P＜0.05).③LSBA、LSPM及LSAP均与VVI呈负相关(P＜0.01).进一步多元线性回归分析,LSAP、RWT、LVMI及SW是VVI的独立预测指标,标准回归系数分别为-0.613、-0.290、0.290和-0.205(P＜0.05).结论 DMN患者心脏-血管耦联,DNA患者心脏-血管脱耦联.左心室LSAP能独立反映心脏-血管耦联.
목적 응용초성기술연구Ⅱ형당뇨병환자심장-혈관우련.방법 Ⅱ형당뇨병환자80례,분위사혈분수(EF)정상조(DMN조,EF≥50％)40례,EF감저조(DMA조,EF＜50％)40례；건강지원자42례작위대조조.측량좌심실상대실벽후도(RWT)、질량지수(LVMI)、매박량(SV),계산매박공(SW)、심솔혈압승적(RPP)、순배혈관조력지수(SVRI)、좌심실수축말기탄성(Ees)、유효동맥탄성(Ea)화심장-혈관우련지수(VVI).획취좌심실기저(LSBA)、유두기(LSPM)화심첨수평적종향응변(LSAP).결과 ①여대조조비교,DMN조RWT、LVMI증가(P＜0.01),LSBA、LSPM급LSAP감저(P＜0.01).DMA조RWT감저(P＜0.01),LSBA、LSPM급LSAP균감저(P＜0.01).DMA조LSBA、LSPM급LSAP명현저우DMN조(P＜0.01).②여대조조비교,DMA조Ea、VVI、RPP급SVRI증고,Ees감저(P＜0.05),DMN조RPP증고(P＜0.01).DMA조Ea、VVI、RPP、SVRI고우DMN조,Ees저우DMN조(P＜0.05).③LSBA、LSPM급LSAP균여VVI정부상관(P＜0.01).진일보다원선성회귀분석,LSAP、RWT、LVMI급SW시VVI적독립예측지표,표준회귀계수분별위-0.613、-0.290、0.290화-0.205(P＜0.05).결론 DMN환자심장-혈관우련,DNA환자심장-혈관탈우련.좌심실LSAP능독립반영심장-혈관우련.
Objective To study the ventricular-arterial coupling in the patients with type 2 diabetes mellitus (DM) by ultrasound.Methods Eighty patients with DM were divided into 2 groups:normal left ventricular ejection fraction (EF) group (DMN,EF≥50 ％,n =40) and abnormal EF group (DMA,EF＜50％,n =40).At the same time,42 healthy volunteers were selected as a control group.The left ventricular (LV) relative wall thickness (RWT),mass index (LVMI),stroke volume (SV),stroke works (SW),ratepressure product (RPP),systemic vascular resistance index (SVRI),LV end-systolic elastance (Ees),arterial elastance index (Ea) and ventricular vascular index (VVI) were measured and calculated.Longitudinal strain (LS) of myocardial segment including base(LSBA),papillary muscle (LSPM) and apex (LSAP) were analyzed by two-dimensional speckle tracking imaging.Results (1) Compared with the control,the RWT and LVMI were all increased (P ＜0.01),but the LSBA,LSPM and LSAP were decreased (P ＜ 0.01) in the DMN and DMA groups (P ＜0.01).In DMA group,the RWT,LSBA,LSPM and LSAP were decreased (P ＜0.01).Compared with the DMN group,the LSBA,LSPM and LSAP were decreased in DMN group (P ＜0.01).(2) Compared with the control,the Ea,VVI,RPP and SVRI were increased,but the Ees was decreased (P ＜0.05)in DMA group (P ＜0.01).In the DMN,RPP was increased compared with the control group (P ＜0.01).Compared with the DMN group,the Ea,VVI,RPP and SVRI were increased,but Ees was decreased in the DMA (P ＜0.05).(3)The LSBA,LSPM and LSAP were all positively correlated with VVI(P ＜0.01).Multiple regression analysis showed that the LSAP,RWT,LVMI and SW were independent predictor of VVI (b' =-0.613,-0.290,0.290 and-0.205,P ＜ 0.05).Conclusions The ventricular-arterial coupling is normal in the DMN group,but is abnormal in DNA group.LSAP is independent predictors for ventricular-arterial coupling.