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目的评价糖尿病早期糖化血红蛋白(Hb A1c)与心肌背向散射积分及心功能之间的关系。方法入选60例无心脏相关疾病的2型糖尿病患者为糖尿病组,同时选取56例年龄、性别相匹配的健康志愿者为对照组。对两组患者行超声心动图常规指标及心肌背向散射积分检查。糖尿病组患者测定Hb A1c水平。结果两组心肌收缩功能指标的差异无统计学意义(P>0.05)。糖尿病组二尖瓣舒张晚期峰值流速(A)高于对照组(P<0.01),E/A低于对照组(P<0.01),等容舒张期时间(IVRT)较对照组延长(P<0.05)。糖尿病组室间隔背向散射积分标化值(IVS-IBS%)和左室后壁背向散射积分标化值(LVPW-IBS%)高于对照组(P<0.01)。糖尿病组室间隔和左室后壁的背向散射积分周期变化幅度(CVIB)低于对照组(P<0.05)。Hb A1c与E/A(r=-0.31,P<0.05)呈负相关。Hb A1c与IVS-IBS%(r=0.58,P<0.01),LVPW-IBS%(r=0.55,P<0.01)呈正相关。IVS-IBS%与E/A(r=-0.35,P<0.05)呈负相关,LVPW-IBS%与E/A(r=-0.35,P<0.05)呈负相关。结论 2型糖尿病患者在心肌收缩功能受损之前即存在心肌声学及舒张功能的异常改变。背向散射积分是检测2型糖尿病患者早期心肌损伤的有效工具,2型糖尿病患者Hb A1c与左室心肌背向散射积分具有相关性。
Objective To evaluate the relationship between early diabetic glycosylated hemoglobin (Hb A1c) and myocardial backscatter integration and cardiac function. Methods Sixty patients with type 2 diabetes without heart-related disease were selected as diabetes mellitus group. At the same time, 56 healthy volunteers with the same age and genders were selected as the control group. The two groups of patients underwent echocardiography routine indexes and myocardial backscatter integral examination. Patients with diabetes mellitus were tested for Hb A1c levels. Results There was no significant difference in myocardial systolic function between the two groups (P> 0.05). The mitral diastolic peak flow velocity (A) in diabetic group was higher than that in control group (P <0.01), E / A was lower than that in control group (P <0.01), and IVRT was longer than that in control group (P < 0.05). IVS-IBS% and LVPW-IBS% in DM group were higher than those in control group (P <0.01). The CVIB of ventricular septum and left ventricular posterior wall in DM group was lower than that in control group (P <0.05). Hb A1c was negatively correlated with E / A (r = -0.31, P <0.05). Hb A1c was positively correlated with IVS-IBS% (r = 0.58, P <0.01) and LVPW-IBS% (r = 0.55, P <0.01). IVS-IBS% was negatively correlated with E / A (r = -0.35, P <0.05), and LVPW-IBS% was negatively correlated with E / A (r = -0.35, P <0.05). Conclusion Patients with type 2 diabetes have abnormal changes of myocardial acoustics and diastolic function before myocardial contractile function is impaired. Backscatter integration is an effective tool to detect early myocardial damage in patients with type 2 diabetes. Hb A1c in patients with type 2 diabetes is associated with left ventricular myocardial backscatter integration.