天津医药

• 论著 • 上一篇    下一篇

超声TVI技术评价冠心病合并糖尿病患者心室舒缩同步性的研究

李秀月1,周长钰2   

  1. 1. 天津市 中国人民武装警察部队医学院附属医院 心内科
    2. 天津医科大学第二医院心脏科
  • 收稿日期:2010-12-30 修回日期:2011-04-29 出版日期:2011-10-15 发布日期:2011-10-15
  • 通讯作者: 李秀月

The Study on the Systolic and Diastolic Ventricular Syn- chronization in Patients with Coronary Heart Disease Complicating Diabetes Mellitus Evaluated by Doppler Tissue Imaging Technology

  • Received:2010-12-30 Revised:2011-04-29 Published:2011-10-15 Online:2011-10-15

PDF (PC)

2150

摘要： [摘要] 目的：应用超声组织速度显像(TVI)技术检测无心衰症状的冠心病合并糖尿病患者心肌同步性运动。方法：选取冠心病患者127例作为研究组，分为冠心病合并糖尿病组(CHD-DM组)和冠心病无糖尿病组(CHD-NG组)，⑴ 二维超声切面测量及计算室间隔(IVS)及左室后壁厚度(LVPW)、左室收缩和舒张末内径(LVEDs和LVEDd)及容积(LVEVs和LVEVd)、左心室射血分数(LVEF)。⑵超声TVI模式下测量收缩期和舒张早期左、右室基底段和中间段共14节段的达峰时间(Ts和Te)，并计算左室12节段收缩和舒张达峰时间平均值(Ts-12-LV、Te-12-LV)、左室12节段收缩达峰时间标准差(Ts-12-SD)和收缩及舒张达峰时间最大差值(Ts-12-diff、Te-12-diff)及右室2节段收缩和舒张达峰时间平均值(Ts-2-RV、Te-2-RV)。结果： CHD-DM组左右室11个节段Ts、Ts-12-LV、Ts-2-RV、Ts-12-SD及Ts-12-diff与CHD-NG组无明显差异(p＞0.05)，以Ts-12-SD＞33 ms为标准，CHD-DM组达此标准者占17例(25.00%)，CHD-NG组为11例(18.64%)，以Ts-12-diff＞100 ms为标准，两组不同步者比例分别为50%(34/68)和28.8%(17/59)，p＜0.01。两组Te-12-diff比较无统计学意义(p＞0.05)，以Te-12-diff＞100 ms为室内舒张不同步标准，两组分别占47.1%和25.4% (p＜0.01)。结论：无心衰症状QRS时限正常的冠心病患者心室收缩及舒张达峰时间最大差值均明显延长，合并糖尿病者尤为显著，提示冠心病患者心脏的收缩及舒张同步性减低，糖尿病可使其加重。

关键词: 多普勒组织速度成像, 冠心病, 糖尿病, 心脏同步化

Abstract: ABSTRACT Objective: To detect the ventricular synchronization in coronary heart disease patients with no heart failure sympathion and the effection of the combination with diabetes mellitus(DM) by Dopler tissue velocity imaging (TVI) technology. Methods: Selected127 cases of patients with coronary heart disease as the study group which was divided into groups with diabetes with coronary heart disease (CHD-DM group) and non-diabetic coronary heart disease (CHD-NG group). ⑴To measure and calculate the interventricular septum(IVS) and left ventricular posterior wall(LVPW) thickness, the left ventricular end systolic and diastolic diameter (LVEDs and LVEDd) and the volume (LVEVs and LVEVd), left ventricular ejection fraction(LVEF) . ⑵To measure time to peak velocity at systolic and early diastolic phase (Ts and Te) in the base and interlude altogether 14 segments of left and right ventricular in all subjects. To calculate and compare the average time of Ts and Te in left ventricular 12 segments (Ts-12-LV and Te-12-LV), the 12 segments standard deviation of Ts (Ts-12-SD) ,the 12 segmental maximal Ts and Te difference (Ts-12-diff and Te-12-diff) and the average time of Ts and Te in right ventricular 2 segments(Ts-2-RV and Te-2-RV). Results: 1. The Ts in 11 segments of left ventricular, Ts-12-LV, Ts-2-RV, Ts-2-RV and Ts-12-diff were failed to demonstrate any statistically significant differences between CHD-DM group and CHD-NG group (p＞0.05). by the Ts-12-SD＞33 ms as the standard , CHD-DM group who achieve this standard were 17 cases, 11 cases of the control group. To Ts-12-diff＞100 ms as the standard, the ratio of the two groups were 50%(34/68) and 28.8%(17/59), p＜0.01. the Te-12-diff were also failed to demonstrate any statistically significant differences between the two group(p＞0.05)，but under the standard of Te-12-diff＞100 ms, the two groups accounted for 47.1% and 25.4% (p＜0.01). 2.In the CHD-DM group Vs and Ve in most segments of left and right ventricular were lower than that of CHD-NG group, especially in group of CHD-DM and CRBBB(p＜0.05 or p＜0.01). Conclusion: The Ts-12-diff and Te-12-diff in patients with coronary heart disease who didn’t have symptoms of heart failure and unnormal QRS duration were significantly longer, especially in patients who had coronary heart disease with diabetes mellitus, suggesting that the systolic and diastolic synchronization was reduce in patients with coronary heart disease, diabetes can increase it.

Key words: Dopler tissue velocity imaging, Coronery heart disease, Diabetes mellitus, Cardiac synchronization