CAJ | 학술논문

目的：探讨多普勒超声结合血浆脑钠肽（BNP）对2型糖尿病心肌病变的早期诊断价值。方法：选择96例符合诊断标准的住院患者，根据多普勒超声测定二尖瓣舒张早期峰值速度（Ea），舒张晚期峰值速度（Aa），据Ea峰/Aa峰小于＜1和≥1分为研究组和对照组，研究对象进行统一生化指标和血浆脑钠肽化验、十二导联心电图检查和M型二维超声心动图检测心脏四腔内径及心泵功能，记录左房前后径、左室内径（舒张/收缩）、收缩末期容积（ESV）、舒张末期容积（EDV）、射血分数（EF）、收缩分数（FS）、心搏出量（SV）等数值，进行统计比较。结果：异常组除左室内径（舒/缩）外其他选定指标与正常组和对照组比较均有统计学意义（P＜0.01）；对照组和正常组比较只有FS（％）和SV（ml）比较有显著性差异，P＜0.05；对可能相关因素分析发现糖尿病患病年限与心室的舒缩相关（γ=0.234，γ=0.278，P＜0.05），糖化血红蛋白与心肌内分泌（γ=-0.375，P＜0.05）和心泵功能密切相关（γ=0.630， P＜0.05）。结论：组织多普勒超声对糖尿病早期心肌病变无创伤性的诊断作用优势突出，并结合血浆脑钠肽的化验，更提高了诊断的准确性及敏感性，值得临床推广应用。
목적：탐토다보륵초성결합혈장뇌납태（BNP）대2형당뇨병심기병변적조기진단개치。방법：선택96례부합진단표준적주원환자，근거다보륵초성측정이첨판서장조기봉치속도（Ea），서장만기봉치속도（Aa），거Ea봉/Aa봉소우＜1화≥1분위연구조화대조조，연구대상진행통일생화지표화혈장뇌납태화험、십이도련심전도검사화M형이유초성심동도검측심장사강내경급심빙공능，기록좌방전후경、좌실내경（서장/수축）、수축말기용적（ESV）、서장말기용적（EDV）、사혈분수（EF）、수축분수（FS）、심박출량（SV）등수치，진행통계비교。결과：이상조제좌실내경（서/축）외기타선정지표여정상조화대조조비교균유통계학의의（P＜0.01）；대조조화정상조비교지유FS（％）화SV（ml）비교유현저성차이，P＜0.05；대가능상관인소분석발현당뇨병환병년한여심실적서축상관（γ=0.234，γ=0.278，P＜0.05），당화혈홍단백여심기내분비（γ=-0.375，P＜0.05）화심빙공능밀절상관（γ=0.630， P＜0.05）。결론：조직다보륵초성대당뇨병조기심기병변무창상성적진단작용우세돌출，병결합혈장뇌납태적화험，경제고료진단적준학성급민감성，치득림상추엄응용。
Objective: To study of plasma brain natriuretic peptide (BNP) by doppler imaging and the value in early diagnosis of myocardial lesion in type 2 diabetes . Methods: 96 cases of hospitalized patients of meeting the diagnostic criteria were selected in which mitral peak early diastolic velocity (Ea) and late diastolic peak velocity (Aa) were measured according to Doppler sonographic . All cases were divided into study group and control group according to the Ea peaks /Aa smaller than 1 and≥1.Biochemical indices, plasma brain natriuretic peptide assay;twelve lead electrocardiogram,M type two-dimensional ultrasound heartbeat map detection heart four chamber diameter and cardiac pump function;the left atrial diameter,left ventricular diameter (diastolic/systolic),end systolic volume (ESV);end diastolic volume (EDV);shoot ejection fraction (EF),fractional shortening (FS),cardiac output (SV) numerical were observed and statistical comparisons in two groups . Results: The abnormal group except for left ventricular diameter(Shu/shrinkage);other selected index in the normal group and the control group were statistically significant(P<0.01);FS(%)and SV(ml) were only significant difference in the control group and the normal group (P<0.05).The possible correlated factors analysis showed that duration of diabetes and left ventricular diastolic,glycosylated hemoglobin and cardiac endocrine and cardiac pump function is closely correlation (γ=0.234,0.278;-0.375 and 0.630,P<0.05). Conclusion: The advantage of tissue doppler imaging diagnosis of non traumatic on myocardial lesions in diabetic early prominent is highlight,which combine with plasma brain natriuretic peptide assay can improve the diagnostic accuracy,sensitivity,and be worthy of clinical application.