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目的探讨组织多普勒(TDI)测定糖尿病肾病患者左心室及右心室Tei指数在评价心室功能方面的临床应用价值。方法将189例患者分成健康对照组60例、慢性肾功能衰竭中非糖尿病肾病组69例及糖尿病肾病组60例,分别测量3组左、右心室常规超声心动图参数,并应用TDI技术测算左、右心室Tei指数并进行比较研究。结果慢性肾功能衰竭患者非糖尿病肾病组患者左、右心室的Tei指数分别为0.45±0.11,0.36±0.10;糖尿病肾病组患者左、右心室Tei指数分别为0.48±0.11,0.40±0.09;健康对照组的Tei指数分别为0.43±0.08,0.33±0.09,3组中非糖尿病肾病组和糖尿病肾病组患者分别与健康对照组Tei指数比较差异有统计学意义(Tei左心室:t1=1.994,t2=2.109,Tei右心室:t1=1.292、t2=2.414,P均<0.05),且糖尿病肾病组患者的Tei指数较非糖尿病肾病组患者显著增大(Tei左心室:t3=2.277,Tei右心室:t3=2.364,P均<0.05),临床表现为舒张功能障碍。结论采用TDI技术测量Tei指数更加简便、敏感且能有效和综合评价糖尿病肾病患者左、右心室功能障碍。对其心室整体功能的评价是一个较好的指标。
Objective To investigate the clinical value of Tissue Doppler (TDI) in the determination of left ventricular and right ventricular Tei index in patients with diabetic nephropathy in the evaluation of ventricular function. Methods 189 patients were divided into healthy control group 60 cases, chronic renal failure in non-diabetic nephropathy group 69 cases and diabetic nephropathy group 60 cases were measured three groups of left and right ventricular routine echocardiography parameters, and the application of TDI technique to measure the left , Right ventricular Tei index and comparative study. Results The Tei index of left ventricle and right ventricle of non-diabetic nephropathy patients were 0.45 ± 0.11 and 0.36 ± 0.10, respectively. The Tei index of left ventricle and right ventricle in diabetic nephropathy group were 0.48 ± 0.11 and 0.40 ± 0.09, respectively. The healthy controls Tei index were 0.43 ± 0.08 and 0.33 ± 0.09, respectively. The Tei index of patients with non-diabetic nephropathy and diabetic nephropathy were significantly different from that of healthy controls (Tei left ventricle: t1 = 1.994, t2 = (Tei right ventricle: t1 = 1.292, t2 = 2.414, P <0.05), and the Tei index of diabetic nephropathy group was significantly higher than that of non-diabetic nephropathy group (Tei left ventricle: t3 = 2.277, Tei right ventricle: t3 = 2.364, P <0.05). The clinical manifestations were diastolic dysfunction. Conclusion It is simpler and sensitive to measure Tei index with TDI technique, which can effectively and comprehensively evaluate the left and right ventricular dysfunction in patients with diabetic nephropathy. Evaluation of the overall ventricular function is a better indicator.