超声新技术对早期糖尿病心脏病变左室收缩功能异常病理基础的评价

Evaluation on the pathologic basis of left ventricular systolic dysfunction in patients with early diabetic heart disease using new echocardiographic tools

关键词:  超声心动描记术  糖尿病  心脏功能  多普勒组织成像  背向散射积分成像

Key words:  echocardiography  diabetes mellitus  ventricular function  doppler tissue imaging  integrated backscatter imaging

摘要:

目的　探讨多普勒组织技术(DTI)及背向散射积分技术(IBS)在检测早期糖尿病心脏病变左室收缩功能异常病理基础方面的临床价值。　方法　36例糖尿病患者及25例健康人，应用DTI分别测量左室6个壁收缩期峰值速度（Sa），应用IBS分别测量室间隔及左室后壁的校正背向散射积分（IBS%）及其周期变异幅度（CVIB）。并计算有统计学差异的IBS与DTI参数之间的相关关系。　结果　与对照组比较，糖尿病组左室壁平均Sa显著减低（P<0.05)，下壁及前间隔Sa均显著低于对照组（P<0.01)；糖尿病组室间隔IBS%显著增高（P<0.05)，左室后壁CVIB显著减低（P<0.01)。间隔的IBS%与前间隔Sa及左室壁平均Sa呈显著负相关（分别为r=-0.524, P<0.01; r=-0.506, P<0.01），与下壁Sa呈显著负相关（r=-0.383, P<0.05）；左室后壁CVIB与下壁Sa及左室壁平均Sa皆呈显著正相关（分别为r=0.469, P<0.01; r=0.415, P<0.01）。　结论　DTI及IBS技术能够无创检测出早期糖尿病心脏病变左室收缩功能异常病理基础。

Abstract:

[Abstract] Objective To determine whether Doppler tissue imaging (DTI) and Integrated backscatter imaging (IBS) are valuable for clinical detection of the pathologic basis of left ventricular (LV) systolic dysfunction in early diabetic heart disease. 　Methods Totally 36 diabetic patients and 25 healthy controls were studied. Peak systolic velocity (Sa) at the mitral annulus of each of six LV walls was measured using DTI. Calibrated IBS (IBS%) and cyclic variation in IBS (CVIB) at the interventricular septum and posterior LV wall were acquired using IBS. Correlation was made between the parameters of DTI and IBS which had significant difference between the two groups. 　Results　Compared with that of controls, the mean Sa of six LV walls of diabetic patients decreased significantly (P<0.05). Sa of inferior and anteroseptal LV walls were lower significantly in diabetic patients than in controls (all P<0.01). Compared with that of controls, IBS% of the interventricular septum increased significantly (P<0.05) and CVIB of posterior LV wall decreased significantly (P<0.01). IBS% of the interventricular septum correlated negatively with Sa of anteroseptal and inferior LV wall and the mean Sa of six LV walls (respectively, r=-0.524, P<0.01; r=-0.383, P<0.05; r=-0.506, P<0.01). CVIB of posterior LV wall correlated positively with Sa of inferior LV wall and the mean Sa of six LV walls (respectively, r=0.469, P<0.01; r=0.415, P<0.01). 　Conclusion TDI and IBS may provide non-invasive tools for clinical detection of the pathologic basis of LV systolic dysfunction in early diabetic heart disease.