超声背向散射积分技术评价2型糖尿病患者心肌病变探究.docVIP

超声背向散射积分技术评价2型糖尿病患者心肌病变探究 　 作者：郭沫化 倪锐志 顾云 李佐才 缪 英 【摘要】 目的 探讨心肌背向散射积分(integrated backscatter，IBS)技术在评价2型糖尿病患者心肌病变中的临床价值。方法 对40例2型糖尿病患者、20例健康人用IBS技术测定室间隔(IVS)和左室后壁(LVPW)心肌的心动周期时间平均背向散射积分(AII)、背向散射积分标化值(IBS%)、背向散射积分周期性变异幅度(CVIB)，并行常规超声心动图检查，计算左室心肌重量。结果 (1)与对照组相比，糖尿病组室间隔和左室后壁中部的IBS%明显增高［(3.8±1.4)vs(2.7±0.9)和(3.63±1.34)vs(2.58±1.07)，Plt;0.01］，CVIB明显减低［(8.9±2.2)vs(10.3±1.7)和(10.4±2.7)vs(13.2±5.3)，Plt;0.05］，且室间隔IBS%与Ep/Ap 呈负相关(r=-0.46、Plt;0.01)，CVIB与Ep/Ap呈正相关(r=0.69、Plt;0.01)；(2)糖尿病组左室心肌重量增加。结论 心肌背向散射积分参数能早期反映2型糖尿病患者心肌的组织病理改变。 【关键词】 2型糖尿病 背向散射积分 左室心肌重量 【Abstract】 Objective To evaluate myocardiopathy integrated backscatter (IBS) in patients with type 2 diabetes mellitus.Methods Ultrasonic integrated backscatter(IBS) and conventional echocardiography were examined in forty patients with type 2 diabetes mellitus and twenty normal subjects.Echocardiographic indices were measured as follows： trans-mitral velocity and velocity time integral，pulmonary venous velocity，mitral annulus velocity and the time averaged value of IB (IBS)，the calibrated time-averaged value of IB (IBS%)，the magnitude of the cyclic variation of IB (CVIB) and left ventricular weight mass(LVWM).Results (1) The IBS% of septum and left ventricular posterior wall was significantly higher in diabetic patients than those in the control group，while the CVIB lower (Plt;0.05).The correlation between IBS% and CVIB of septum and transmitral flow indexes E/A ratio was significant (r=-0.46；Plt;0.01；r=0.69；Plt;0.01).(2) Left ventricular weight mass in diabetic patients had increased (Plt;0.05).Conclusion Ultrasonic integrated backscatter could provide a early method of assessing myocardial histological changes in type 2 diabetes mellitus patients. 【Key words】 type 2 diabetes mellitus integrated backscatter left ventricular weigat mass 超声背向散射积分(intergrated backscatter，IBS)技术是近年发展起来的新型无创性超声组织定征技术，它结合计算机自动处理、分析二维图像中取样容积内背向散射信号的强度大小，而定量评价组织器官的结构特性与功能状态。超声心肌组织定征是基于心肌病理改变时，必然同时有心肌物理(声学)特性改变的理论，通过检测IBS参数的变化来评价和分析心肌组织声学