·糖尿病与心血管病·

　　【摘要】 目的 探讨常规经胸超声心动图(TTE)评估糖尿病患者左心室整体灌注功能的可行性及其与糖尿病病程的相关性。 方法 选取经冠脉造影证实无冠脉狭窄的T2DM患者(T2DM组)60例和健康对照(NC)者60名。采用多普勒和三维超声心动图测量冠状窦血流和左心室质量(LVM)。左心室整体灌注量由冠状窦血流量除以左心室体积计算所得，并分析其与糖尿病病程的相关性。 结果 与NC组比较，T2DM组LVM增加[(163.00±17.94) vs (154.35±19.44) g，P<0.05]，静息时左心室灌注量减少[(1.72±0.33) vs (6.04±4.77) ml/(min·g)，P<0.01]。静息时左心室整体灌注量与糖尿病病程呈负相关(r=-0.533,P<0.001)。 结论 TTE可有效地检测出经冠脉造影证实无冠脉狭窄的糖尿病患者在静息时存在冠脉微血管功能障碍。糖尿病患者的左心室整体灌注量减少，且与其糖尿病病程呈负相关。

　　【关键词】 冠脉微血管功能障碍;糖尿病;左心室灌注;冠状窦血流;左心室质量;经胸超声心动图

　　【Abstract】 Objective Feasibility evaluation of the thoracic echocardiography (TTE) for left ventricular whole perfusion function measurement in diabetic patients. And study the association between left ventricular whole perfusion function and the duration of T2DM. Methods A total of 120 subjects were enrolled in this study including 60 T2DM patients without coronary artery stenosis confirmed by coronary angiography (T2DM group) and 60 healthy controls (NC group). Doppler and 3 d echocardiography were used to measure coronary sinus blood flow and left ventricular mass (left ventricular mass, LVM) respectively. Left ventricular whole perfusion was calculated as follows: coronary sinus blood flow divided by the number of left ventricular volume. The association between left ventricular whole perfusion function and the duration of T2DM was analyzed. Results LVM increased in T2DM group compared with NC group[(163.00±17.94) g vs (154.35±19.44), P<0.05]. Resting left ventricular perfusion significantly reduced in T2DM group compared with NC group[(1.72±0.33) vs (6.04±4.77) ml/min, P<0.01]. A negative correlation could be seen between resting left ventricular perfusion and diabetes duration (r=0.533, P<0.001). Conclusion TTE can effectively detect the resting coronary microvascular dysfunction in diabetic patients without coronary stenosis confirmed by coronary angiography. Left ventricular whole perfusion decreased in T2DM and has negative correlation with diabetes duration.

　　【Key words】 Coronary microvascular dysfunction. Diabetes; Left ventricular perfusion; Coronary sinus blood flow; Left ventricular mass; The thoracic echocardiography.