【摘要】 目的应用定量组织速度成像(QTVI)技术测定非胰岛素依赖型糖尿病患者左室心肌收缩功能变化,以探讨糖尿病患者是否存在心内膜下心肌缺血。方法利用QTVI技术分别测量46例非胰岛素依赖型糖尿病患者和23例正常人的二尖瓣环收缩期长轴方向峰值运动速度(Sm)和室间隔左室面、右室面、左室后壁内外膜面下心肌短轴方向收缩期峰值运动速度(Vs)、收缩期心肌速度梯度(MVG)。M型超声测量二尖瓣环活动幅度(Dm)、左室射血分数(LVEF)。结果①糖尿病组与正常对照组的Dm、LVEF值均在正常范围,差异无统计学意义(P>0.05);②糖尿病患者Sm值减低[糖尿病组(6.01±1.50)cm/s对正常对照组(6.76±1.63)cm/s,P<0.05];③糖尿病患者室间隔和左室后壁的MVG值均低于正常对照组,差异有统计学意义[前室间隔:(-0.57±0.82)s-1对(-1.10±0.50)s-1;左室后壁:(1.38±0.97)s-1对(2.36±2.22)s-1)]。结论糖尿病患者左室心内膜下心肌收缩功能减低,提示患者存在左室心内膜下心肌缺血。更多还原

【Abstract】 Objective To explore whether there was subendocardial myocardial ischemia in patients with type Ⅱ diabetes mellitus(DM), and to assess the left ventricular myocardial systolic functions by quantitative tissue velocity imaging(QTVI). Methods In 46 patients with DM(DM group) and 23 healthy subjects(healthy group), QTVI was performed on apical four chamber, two chamber, and apical long axis views. Longitudinal peak systolic velocities(Sm) were measured at the level of mitral annulus. The subendocardial and subepicardial systolic velocities of the left ventricular posterior wall (LVPW) and inter-ventricular septum(IVS) in left ventricular parasternal long-axis view were measured by QTVI. And systolic myocardial velocity gradient(MVG) between endocardium and epicardium was calculated. Left ventricular ejection fraction(LVEF) and the displacement of mitral annulus(Dm) were measured using M-mode ultrasound. Results ①There were no statistical difference in LVEF and mitral annular Dm between the patients with DM and healthy subjects; ②The longitudinal myocardial systolic velocity at the level of mitral annulus in the patients with diabetes mellitus decreased DM group( 6.01 ± 1.50 )cm/s vs healthy group ( 6.76 ± 1.63 )cm/s,P< 0.05 ; ③Compared with healthy group, the systolic MVG of IVS in DM group was significantly decreased(P< 0.05 ), so was the systolic MVG of LVPW IVS:DM group ( -0.57 ± 0.82 )s~ -1 vs normal group ( -1.10 ± 0.50 )s~ -1 ;LVPW:DM group ( 1.38 ± 0.97 )s~ -1 vs normal group ( 2.36 ± 2.22 )s~ -1 . Conclusions The systolic functions of subendocardial myocardium in patients with type Ⅱ DM were injured, so it could be inferred that there was subendocardial myocardial ischemia in patients with type Ⅱ DM.更多还原