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背景:彩色多普勒超声可检出2型糖尿病患者的早期心肌病变,运动负荷试验配合彩色多普勒超声检查对于该病变的检出又能起到什么作用呢?目的:比较分析运动负荷试验加彩色多普勒超声检查与单纯彩色多普勒超声检查对2型糖尿病患者左室舒张功能降低的早期评估作用。设计:病例-对照及自身,前后对照观察。单位:一所市级医院电诊科和内分泌科。对象:选择2004-03/12沈阳市红十字会医院内分泌科住院的2型糖尿病患者36例,男25例,女11例。纳入的糖尿病患者均无心血管疾病并发症,且自愿参加。正常对照组32例,为同期本院体检健康自愿者,男20例,女12例。方法:应用美高仪平板运动试验仪给予两组运动负荷。运动前(静息状态下)及运动负荷结束后即刻应用Vivid4彩色多普勒超声诊断仪检测E峰峰值流速、A峰峰值流速、E峰峰值流速/A峰峰值流速比值、等容舒张期时间。主要观察指标:两组运动负荷前后心功能指标比较。结果:34例糖尿病患者完成了运动负荷试验,1例出现频发室性期前收缩,另1例出现心前区疼痛中止试验。对照组32例均完成试验。①患者组运动前E峰峰值流速/A峰峰值流速比值明显低于对照组运动前(0.90±0.25,1.40±0.30,P<0.05);等容舒张期时间明显大于对照组运动前犤(112.07±20.16),(98.45±8.55)ms,P<0.05犦。②患者组运动负荷后E峰峰值流速/A峰峰值流速比值明显低于对照组运动后(0.62±0.12,1.28±0.87,P<0.01);等容舒张期时间明显大于对照组运动后犤(138.10±19.21),(97.37±9.61)ms,P<0.01犦。结论:彩色多普勒超声检查可早期监测和评估2型糖尿病患者的心功能变化;运动负荷试验并彩色多普勒超声检查,因加了运动负荷的诱发作用,可使结论更准确客观,更有早期的价值。
BACKGROUND: Color Doppler echocardiography can detect early myocardial lesions in patients with type 2 diabetes mellitus. What are the effects of exercise load test combined with color Doppler ultrasonography on the detection of this disease? OBJECTIVE: To compare and analyze the changes of exercise load test Early assessment of left ventricular diastolic function in patients with type 2 diabetes by color Doppler ultrasonography and plain color Doppler ultrasonography. Design: Case - Control and Self, Control before and after observation. Unit: a municipal hospital electrodiagnosis and endocrine department. PARTICIPANTS: A total of 36 type 2 diabetic patients admitted to Department of Endocrinology, Shenyang Red Cross Hospital from March 2004 to December 2004 were selected, including 25 males and 11 females. None of the included diabetic patients had cardiovascular complications and participated voluntarily. 32 cases of normal control group, for the same period in our hospital healthy volunteers, 20 males and 12 females. Methods: The exercise load was given to two groups by using the Microlight treadmill tester. Vivo4 color Doppler sonography was used to detect the peak flow velocity of E-peak, the peak flow rate of A peak, the peak flow rate of E peak / the peak flow rate of A peak, the isovolumetric diastolic time (before resting) and the end of exercise load . MAIN OUTCOME MEASURES: Comparison of cardiac function before and after exercise load in two groups. RESULTS: Thirty-four patients with diabetes completed the exercise load test, one had frequent premature ventricular contractions, and the other had an anterior precordial pain stop test. The control group of 32 patients completed the test. (1) Before exercise, the ratio of peak value of E-peak to peak-to-peak ratio of A peak was significantly lower in patients than in control group before exercise (0.90 ± 0.25,1.40 ± 0.30, P <0.05); isovolumic diastolic time was significantly higher than that in control group ± 20.16), (98.45 ± 8.55) ms, P <0.05 犦. (2) After the exercise load, the ratio of peak value of E peak to peak value of A peak was significantly lower than that of the control group (0.62 ± 0.12,1.28 ± 0.87, P <0.01); the isokinetic diastolic time was significantly longer than that of the control group 138.10 ± 19.21), (97.37 ± 9.61) ms, P <0.01 犦. Conclusion: Color Doppler ultrasonography can early monitor and evaluate the changes of cardiac function in patients with type 2 diabetes mellitus. Exercise stress test and color Doppler echocardiography can make the conclusion more accurate and objective because of the inducing effect of exercise load Have early value.