CAJ | 학술논문

目的：筛选检测糖尿病早期心功能损害的超声心动图敏感指标，且评价血糖控制水平与心功能之间的关系。方法入选56例无心脏及相关疾病的2型糖尿病患者为糖尿病组，同时选取52例年龄、性别相匹配的健康志愿者为对照组。两组患者均行超声心动图常规指标及组织多普勒检查。糖尿病组患者测定糖化血红蛋白（ HbA1c）水平。结果两组病例收缩功能指标无显著差异（ P >0.05）。糖尿病组二尖瓣舒张晚期峰值流速（ A）水平高于对照组（ P <0.01），E/A低于对照组（ P <0.01），等容舒张期时间（ IVRT）较对照组延长（ P <0.05）。糖尿病组左室心肌平均舒张早期峰值速度（Eˊ）、Eˊ/Aˊ低于对照组（ P <0.01），糖尿病组左室心肌平均舒张晚期峰值速度（Aˊ）、E/Eˊ高于对照组（ P<0.01）。HbA1c与E/A（ r =-0.310，P <0.05）、Eˊ（ r =-0.409，P <0.01）、Eˊ/Aˊ（ r =-0.380，P <0.01）呈负相关，并与 E/Eˊ（ r =0.488，P <0.01）呈正相关。结论2型糖尿病患者在收缩功能受损之前即存在舒张功能异常。组织多普勒是检测2型糖尿病患者早期舒张功能异常的有效工具，2型糖尿病患者HbA1c 与左室舒张功能的敏感指标E/Eˊ具有明显相关性。
목적：사선검측당뇨병조기심공능손해적초성심동도민감지표，차평개혈당공제수평여심공능지간적관계。방법입선56례무심장급상관질병적2형당뇨병환자위당뇨병조，동시선취52례년령、성별상필배적건강지원자위대조조。량조환자균행초성심동도상규지표급조직다보륵검사。당뇨병조환자측정당화혈홍단백（ HbA1c）수평。결과량조병례수축공능지표무현저차이（ P >0.05）。당뇨병조이첨판서장만기봉치류속（ A）수평고우대조조（ P <0.01），E/A저우대조조（ P <0.01），등용서장기시간（ IVRT）교대조조연장（ P <0.05）。당뇨병조좌실심기평균서장조기봉치속도（Eˊ）、Eˊ/Aˊ저우대조조（ P <0.01），당뇨병조좌실심기평균서장만기봉치속도（Aˊ）、E/Eˊ고우대조조（ P<0.01）。HbA1c여E/A（ r =-0.310，P <0.05）、Eˊ（ r =-0.409，P <0.01）、Eˊ/Aˊ（ r =-0.380，P <0.01）정부상관，병여 E/Eˊ（ r =0.488，P <0.01）정정상관。결론2형당뇨병환자재수축공능수손지전즉존재서장공능이상。조직다보륵시검측2형당뇨병환자조기서장공능이상적유효공구，2형당뇨병환자HbA1c 여좌실서장공능적민감지표E/Eˊ구유명현상관성。
Objective To explore the echocardiographic sensitive indexes for prediction of subclinical cardiac dysfunction and to evaluate the relationship between plasma level of glycosylated hemoglobin(HbA1c)and cardiac function. Methods 56 DM2 patients(48.2 ±7.8 years) without evidence of heart disease and 52 age- and sex-matched normal controls(47. 8 ± 7. 1 years)were enrolled in this study. Indexes of con-ventional echocardiography,tissue Doppler imaging were measured in both groups. The levels of HbA1c in DM2 patients were determined. Results There was no significant difference in systolic indexes between these two groups( P >0. 05). Peak late diastolic mitral velocity(A)was higher ( P <0. 01),E/A was lower( P <0. 01)and isovolumetric relaxation time(IVRT)was longer( P <0. 05)in DM group than those of control group. Mean LV myocardial early diastolic velocity Eˊand Eˊ/Aˊwere lower in DM group than those of control group( P <0. 01). Mean LV myo-cardial late diastolic velocity Aˊand E/Eˊwere higher in DM group than those of control group( P <0. 01). Level of HbA1c was negatively correla-ted with E/A( r = -0. 310,P <0. 05),Eˊ( r = -0. 409,P <0. 01)and Eˊ/Aˊ( r = -0. 380,P <0. 01)and positively correlated with E/Eˊ( r =0. 488,P <0. 01). Conclusion The diastolic dysfunction exists before the damage of systolic function in DM2 patients. Tissue Doppler imaging can be used as sensitive means for early detection of changes of early cardiac function in DM2 patients. Level of HbA1c is related with di-astolic dysfunction.