【摘要】 目的应用背向散射积分(IBS)参数评价高血压病对糖尿病患者心脏结构和功能的影响。方法检测26例血压正常的2型糖尿病患者(DM组)、24例合并高血压病的2型糖尿病患者(DMTH组)和20例正常成人(NC组)心肌的心动周期时间平均IBS、IBS标化值(IBS%)及IBS周期变化幅度(CVIB),同时测定DM组和DMTH组患者二尖瓣环频谱6点的组织多普勒速度,比较各组受检者心肌超声IBS参数,并对DM组和DMTH组患者的CVIB与收缩期峰值运动速度(Sa)进行相关性分析。结果①DM组和DMTH组患者室间隔舒张末期厚度(IVS)、左室后壁舒张末期厚度(LVPW)、舒张早期左室充盈减速时间(EDT)、左室等容舒张时间(IVRT)、左室心肌质量(LVM)及左室心肌质量指数(LVMI)与NC组比较差异有统计学意义(P﹤0.05);DMTH组的左房内径(LA)、LVPW、EDT、IVRT、左室等容收缩时间(IVCT)、LVM及LVMI与DM组比较差异有统计学意义(P﹤0.05)。②与NC组和DM组比较,DMTH组的Sa减低,DM组与NC组间比较差异无统计学意义;与NC组比较,DM组和DMTH组的舒张早期峰值运动速度(Ea)减低,DMTH组和DM组间比较差异无统计学意义;与NC组比较,DM组和DMTH组的舒张晚期峰值运动速度(Aa)增高,且DMTH组高于DM组,差异有统计学意义(P﹤0.05)。DM组和DMTH组Ea/Aa﹤1,NC组Ea/Aa﹥1。③DM组和DMTH组患者IVS和LVPW的IBS%均较NC组增高,且DMTH组高于DM组,DM组和DMTH组IVS与LVPW的CVIB较NC组减低,且DMTH组低于DM组,差异有统计学意义(P﹤0.05)。④IVS及LVPW的CVIB与Sa成直线弱相关(r=0.324,P﹤0.05;r=0.305,P﹤0.05)。结论高血压病可以加重糖尿病患者的心肌病变,心肌IBS参数测定可敏感地早期检测糖尿病患者的心肌病变并判断其程度,指导临床治疗。更多还原

【Abstract】 Objective To evaluate the diagnostic value of ultrasonic integrated backscatter(IBS) technique in detecting myocardial lesion in normotensive and hypertensive patients with type 2 diabetes mellitus.Methods Twenty-six normotensive(DM group),24 hypertensive patients with type 2 diabetes mellitus(DMTH group) and 20 normal subjects(NC group) were enrolled in this study.The time averaged value of IBS,the calibrated time averaged value of IBS(IBS%),and the magnitude of the cyclic variation of IBS(CVIB) were detected.Tissue Doppler velocity of mitral annular in DM and DMTH group were measured,the IBS parameters of each group were compared,then the correlation between CVIB and peak systolic velocity during ejection period(Sa) in DM and DMTH group was analyzed.Results ①Compared with NC group,there was significant difference of interventricular septum(IVS),left ventricular posterior wall(LVPW),ewave deceleration time(EDT),isovolumic relaxation time(IVRI),left ventricular myocardium(LVM) and left ventricular myocarolium index(LVMI) between DM and DMTH group(P﹤0.05).While there was significant difference of left atrial diameter(LA),LVPW,EDT,LVRT,isovolumetric contraction time(LVCT),LVM and LVMI between DM and DMTH group(P﹤0.05).②Compared with NC and DM group,Sa in DMTH group reduced.There was no significant difference between DM group and NC group.Compared with NC group,early diastolic peak velocity(Ea) in DM and DMTH groups reduced.There was no significant difference between DMTM group and DM group.Compared with NC group,late diastolic peak velocity(Aa) in DM and DMTH groups increased,and Aa in DMTH group was higher than that in DM group.Ea/Aa﹤1 in DM and DMTH groups,and Ea/Aa﹥1 in NC group.③The IBS% of the IVS and LVPW was significantly higher in DM and DMTH groups than those in NC group,and it was also higher in DMTH group than in DM group.The CVIB of the IVS and LVPW was significantly lower in DM and DMTH groups than those in NC group,and it was also lower in DMTH group than in DM group(P﹤0.05).④There was a weak linear correlation between CVIB and Sa of IVS and LVPW(r=0.324,P﹤0.05;r=0.305,P﹤0.05).Conclusion Myocardium IBS parameters are helpful in assessing myocardial lesion sensitively and determining of the degrees of myocardium injury in patients with type 2 diabetes mellitus.更多还原