中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2013年
10期
851-856
,共6页
何娟%郝力丹%郭瑞强%陈金玲
何娟%郝力丹%郭瑞彊%陳金玲
하연%학력단%곽서강%진금령
超声心动描记术%糖尿病,2型%心室功能,左%血液动力学现象%瞬时波强
超聲心動描記術%糖尿病,2型%心室功能,左%血液動力學現象%瞬時波彊
초성심동묘기술%당뇨병,2형%심실공능,좌%혈액동역학현상%순시파강
Echocardiography%Diabetes mellitus,type 2%Ventricular function,left%Hemodynamic phenomena%Wave intensity
目的 探讨瞬时波强(wave intensity,WI)和组织多普勒(tissue Doppler imaging,TDI)技术早期评估2型糖尿病患者心血管功能的临床意义.方法 糖尿病患者30例,其中15例病程1～5年(糖尿病1组),15例病程＞5年(糖尿病2组)；对照组为30例健康志愿者.应用WI技术对3组受检者左侧颈总动脉进行检测,获得瞬时加速度波强(W1)、瞬时减速度波强(W2)、负向波面积(NA)、心电图R波顶点到W1顶点的时间(R-W1)、W1顶点到W2顶点的时间(W1-W2)、血管压力-应变弹性模量(Ep)、血管僵硬度(β)、血管顺应性(AC)、经β计算得出的局部脉搏波传播速度(PWVβ)、颈总动脉内-中膜厚度(IMT)等参数；超声心动图测量左室大小、左室射血分数(LVEF)、射血时间(LVET)、舒张早期峰值速度(E)、舒张晚期峰值速度(A)、E/A、等容舒张时间(IVRT)；应用TDI技术获得二尖瓣环水平舒张早期峰值速度(Em),舒张晚期峰值速度(Am)、Em/Am;将三组参数进行比较.结果 ①糖尿病1组和2组β、PWVβ、Ep较对照组显著增大(P＜0.01,P＜0.05),AC较对照组降低(P＜0.05),糖尿病2组IMT较对照组显著增高(P＜0.01),糖尿病2组PWVβ、Ep、IMT较糖尿病1组增大(P＜0.05).②糖尿病2组W2较对照组、糖尿病1组显著升高(P ＜0.01,P＜0.05).③糖尿病1、2组E/A、Em、Em/Am均较对照组显著降低(P ＜0.05,P＜0.01)；糖尿病2组Em较1组降低(P＜0.05).④糖尿病组中,IMT与Ep、β、PWVβ呈显著正相关(r =0.48,P＜0.01;r=0.385,P＜0.05;r =0.478,P＜0.01)；Em与E呈正相关(r =0.404,P＜0.05)；Em/Am与E/Em、E/A呈显著正相关(r =0.602,r=0.559,P＜0.01)；Em与IVRT呈显著负相关(r=-0.653,P＜0.01)；W1与LVEF呈显著正相关(r =0.627,P＜0.01),W1-W2与LVET呈显著正相关(r=0.847,P＜0.01)；W2与各舒张功能参数均无相关.结论 单纯糖尿病患者颈总动脉血管弹性和左心室舒张功能降低,左心室收缩功能变化不显著.
目的 探討瞬時波彊(wave intensity,WI)和組織多普勒(tissue Doppler imaging,TDI)技術早期評估2型糖尿病患者心血管功能的臨床意義.方法 糖尿病患者30例,其中15例病程1～5年(糖尿病1組),15例病程＞5年(糖尿病2組)；對照組為30例健康誌願者.應用WI技術對3組受檢者左側頸總動脈進行檢測,穫得瞬時加速度波彊(W1)、瞬時減速度波彊(W2)、負嚮波麵積(NA)、心電圖R波頂點到W1頂點的時間(R-W1)、W1頂點到W2頂點的時間(W1-W2)、血管壓力-應變彈性模量(Ep)、血管僵硬度(β)、血管順應性(AC)、經β計算得齣的跼部脈搏波傳播速度(PWVβ)、頸總動脈內-中膜厚度(IMT)等參數；超聲心動圖測量左室大小、左室射血分數(LVEF)、射血時間(LVET)、舒張早期峰值速度(E)、舒張晚期峰值速度(A)、E/A、等容舒張時間(IVRT)；應用TDI技術穫得二尖瓣環水平舒張早期峰值速度(Em),舒張晚期峰值速度(Am)、Em/Am;將三組參數進行比較.結果 ①糖尿病1組和2組β、PWVβ、Ep較對照組顯著增大(P＜0.01,P＜0.05),AC較對照組降低(P＜0.05),糖尿病2組IMT較對照組顯著增高(P＜0.01),糖尿病2組PWVβ、Ep、IMT較糖尿病1組增大(P＜0.05).②糖尿病2組W2較對照組、糖尿病1組顯著升高(P ＜0.01,P＜0.05).③糖尿病1、2組E/A、Em、Em/Am均較對照組顯著降低(P ＜0.05,P＜0.01)；糖尿病2組Em較1組降低(P＜0.05).④糖尿病組中,IMT與Ep、β、PWVβ呈顯著正相關(r =0.48,P＜0.01;r=0.385,P＜0.05;r =0.478,P＜0.01)；Em與E呈正相關(r =0.404,P＜0.05)；Em/Am與E/Em、E/A呈顯著正相關(r =0.602,r=0.559,P＜0.01)；Em與IVRT呈顯著負相關(r=-0.653,P＜0.01)；W1與LVEF呈顯著正相關(r =0.627,P＜0.01),W1-W2與LVET呈顯著正相關(r=0.847,P＜0.01)；W2與各舒張功能參數均無相關.結論 單純糖尿病患者頸總動脈血管彈性和左心室舒張功能降低,左心室收縮功能變化不顯著.
목적 탐토순시파강(wave intensity,WI)화조직다보륵(tissue Doppler imaging,TDI)기술조기평고2형당뇨병환자심혈관공능적림상의의.방법 당뇨병환자30례,기중15례병정1～5년(당뇨병1조),15례병정＞5년(당뇨병2조)；대조조위30례건강지원자.응용WI기술대3조수검자좌측경총동맥진행검측,획득순시가속도파강(W1)、순시감속도파강(W2)、부향파면적(NA)、심전도R파정점도W1정점적시간(R-W1)、W1정점도W2정점적시간(W1-W2)、혈관압력-응변탄성모량(Ep)、혈관강경도(β)、혈관순응성(AC)、경β계산득출적국부맥박파전파속도(PWVβ)、경총동맥내-중막후도(IMT)등삼수；초성심동도측량좌실대소、좌실사혈분수(LVEF)、사혈시간(LVET)、서장조기봉치속도(E)、서장만기봉치속도(A)、E/A、등용서장시간(IVRT)；응용TDI기술획득이첨판배수평서장조기봉치속도(Em),서장만기봉치속도(Am)、Em/Am;장삼조삼수진행비교.결과 ①당뇨병1조화2조β、PWVβ、Ep교대조조현저증대(P＜0.01,P＜0.05),AC교대조조강저(P＜0.05),당뇨병2조IMT교대조조현저증고(P＜0.01),당뇨병2조PWVβ、Ep、IMT교당뇨병1조증대(P＜0.05).②당뇨병2조W2교대조조、당뇨병1조현저승고(P ＜0.01,P＜0.05).③당뇨병1、2조E/A、Em、Em/Am균교대조조현저강저(P ＜0.05,P＜0.01)；당뇨병2조Em교1조강저(P＜0.05).④당뇨병조중,IMT여Ep、β、PWVβ정현저정상관(r =0.48,P＜0.01;r=0.385,P＜0.05;r =0.478,P＜0.01)；Em여E정정상관(r =0.404,P＜0.05)；Em/Am여E/Em、E/A정현저정상관(r =0.602,r=0.559,P＜0.01)；Em여IVRT정현저부상관(r=-0.653,P＜0.01)；W1여LVEF정현저정상관(r =0.627,P＜0.01),W1-W2여LVET정현저정상관(r=0.847,P＜0.01)；W2여각서장공능삼수균무상관.결론 단순당뇨병환자경총동맥혈관탄성화좌심실서장공능강저,좌심실수축공능변화불현저.
Objective To evaluate the clinical value of cardiovascular function in patients with type 2 diabetes mellitus by wave intensity and tissue Doppler imaging.Methods According to the course of disease,30 patients with type 2 diabetes mellitus were divided in to two groups:T2DM group 1,the course of disease between 1 year to 5 years; T2DM group 2,the course of disease was longer than 5 years.30healthy volunteers were considered as control group.The parameters of accelerating wave intensity(W1),decelerating wave intensity(W2),negative area(NA),time interval between the R-wave of ECG and the first peak(R-W1),the first and second peaks (W1-W2),elasticity modulus (Ep),stiffness index (β),arterial compliance(AC),pulse wave velocity(PWVβ) and intima media thickness (IMT) were calculated by wave intensity.The left ventricular ejection fraction (LVEF),left ventricular ejection time (LVET),early diastolic peak speed (E),late diastolic peak velocity (A),E / A and isovolumic relaxation time(IVRT) were detected by two dimensional echocardiography.Mitral annular early diastolic peak speeds (Em),late diastolic peak velocity (Am) and Em / Am were detected by tissue Doppler imaging.Then three groups data were recorded and compared.Results Compared with the control group,β,PWVβ,Ep in T2DM group increased significantly(P ＜0.01 or P ＜0.05),while AC decreased(P ＜0.05).IMT in T2DM group 2 was thicker significantly than the control group(P ＜0.01).PWVβ,Ep,IMT in T2DM group 2 were significantly higher than those of T2DM group 1 (P ＜0.05).W2 in T2DM group 2 was significantly higher than those of T2DM group 1 and the control group(P ＜0.01 or P ＜0.05).E/A,Em and Em/Am in T2DM group were significantly lower than those of the control group (P ＜0.05 or P ＜0.01).Compared with T2DM group 1,Em in T2DM group 2 decreased significantly(P ＜0.05).In T2DM group,there were positive correlation between IMT and Ep,β,PWVβ (r =0.48,r =0.385,r =0.478,P ＜0.05 or P ＜0.01),positive correlation between Em and E (r =0.404,P ＜0.05) ;positive correlation between Em/Am and E/Em,E/A (r =0.602,r =0.559,P ＜0.01) ; negative correlation between Em and IVRT (r =-0.653,P ＜0.01);positive correlation between W1 and LVEF (r =0.627,P ＜0.01); positive correlation between W1-W2 and lVET (r =0.847,P ＜ 0.01) ; no correlation between W2 and E/A,E/Em,Em/Am,IVRT(P ＞0.05).Conclusions The elasticity of carotid artery and the diastolic function of left ventricular decreased in T2DM patients,while the systolic function of left ventricular was normal.
