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目的探讨糖尿病前期及T2DM患者左室舒张功能的改变情况。方法通过彩色血流多普勒、组织多普勒(DTI)及生化指标N末端B型钠尿肽前体(NT-proBNP)分别对IGT组、IFG组、T2DM组及正常对照(NC)组进行观察对照。主要检测指标包括舒张早期二尖瓣血流峰值速度(E值)、舒张晚期血流峰值速度(A值)、E/A值、二尖瓣环左侧壁附着处心肌舒张早期运动峰值速度(Em)、舒张晚期运动峰值速度(Am)、Em/Am值、E/Em值及NT-proBNP生化值。结果 E值、A值、E/A值、Am值在NC组、IGT组、IFG组间差异均无统计学意义(P>0.05),T2DM组与以上各组间差异均有统计学意义(P<0.05),Em、Em/Am、E/Em值在4组间两两比较除IGT组与IFG组间外,差异均有统计学意义(P<0.05)。NT-proBNP值在NC组、IGT组、IFG组间差异无统计学意义(P>0.05),T2DM组与以上各组间差异均有统计学意义(P<0.05)。E/Em值与NT-proBNP值之间具有良好相关性(r=0.827,P<0.01)。DTI对舒张功能异常检出率比传统多普勒高(χ2=8.1,P<0.01)。结论 IGT、IFG及T2DM患者均存在心脏舒张功能受损,DTI对舒张功能检测比传统彩色血流多普勒更敏感,NT-proBNP可作为舒张性心功能不全早期诊断的可靠指标。
Objective To investigate the changes of left ventricular diastolic function in patients with pre-diabetes and T2DM. Methods Color Doppler flow imaging (Doppler), tissue Doppler (DTI) and biochemical markers of N-terminal pro-brain natriuretic peptide (NT-proBNP) were used to evaluate the effects of IGT, IFG, T2DM and normal control (NC) Observation and control. The main detection indexes included early peak mitral flow velocity (E), peak diastolic velocity (A), E / A, mitral annular early left ventricular diastolic peak velocity ( Em, the peak diastolic velocity (Am), Em / Am, E / Em and NT-proBNP biochemical values. Results There was no significant difference in E, A, E / A and Am between NC group, IGT group and IFG group (P> 0.05). There was significant difference between T2DM group and the above groups P <0.05). Em, Em / Am and E / Em values were significantly different between the two groups except IGT group and IFG group (P <0.05). There was no significant difference in NT-proBNP between NC group, IGT group and IFG group (P> 0.05). There was significant difference between T2DM group and the above groups (P <0.05). There was a good correlation between E / Em values and NT-proBNP values (r = 0.827, P <0.01). DTI diastolic dysfunction detection rate than the traditional Doppler (χ2 = 8.1, P <0.01). Conclusions Diastolic dysfunction is impaired in patients with IGT, IFG and T2DM. DTI is more sensitive to diastolic function than traditional color Doppler flow imaging. NT-proBNP can be used as a reliable indicator of early diagnosis of diastolic heart failure.