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目的 :利用多巴酚丁胺同时兴奋β1 、β2 和α受体增加心脏负荷的作用 ,评价血压正常非冠心病 型糖尿病患者左心功能的早期变化 ,探讨反映左室舒张功能的部分指标的敏感性。方法 :用多巴酚丁胺负荷试验的常规方案检测 30例 型糖尿病患者左心功能在负荷状态前后的变化 ,并与 2 0例正常人做对照。结果 :糖尿病患者的收缩功能指标 (SV)负荷后明显下降 (P<0 .0 5 ) ,而对照组的 (SV)下降无显著性意义 ,其余各项收缩功能指标的改变两组相同。对照组负荷试验前后左室舒张功能指标 VE/ VA、 VS/ VD、 Ea/ Aa及 L VFP的改变均无显著性意义 ,而糖尿病组负荷试验前后上述指标改变均有显著性意义 (P<0 .0 5～ P<0 .0 0 1)。结论 : 型糖尿病患者在无明显器质性心脏病表现时已存在左心功能障碍 ,尤其是左室舒张功能障碍。多巴酚丁胺负荷试验可提高超声心动图对糖尿病早期左心功能障碍的检出率。
OBJECTIVE: To evaluate the early changes of left ventricular function in patients with normotensive non-coronary heart disease (DM) by using dobutamine to excite β1, β2 and α receptors simultaneously and to evaluate the sensitivity of some indexes reflecting left ventricular diastolic function Sex. Methods: The changes of left ventricular function before and after loading in 30 patients with diabetes mellitus were detected by the dobutamine stress test and compared with 20 normal subjects. Results: The contractile function index (SV) of diabetic patients decreased significantly (P <0.05), while the control group (SV) showed no significant difference. The rest of the systolic function indexes were the same in both groups. The change of left ventricular diastolic function indexes VE / VA, VS / VD, Ea / Aa and L VFP in control group before and after stress test had no significant difference, while the changes of these indexes in diabetes group before and after stress test were all significant (P <0 .0 5 ~ P <0. 0 0 1). Conclusion: Patients with type 2 diabetes have left heart dysfunction, especially left ventricular diastolic dysfunction, in the absence of obvious organic heart disease. Dobutamine stress test may improve the detection rate of echocardiography in early stage of left ventricular dysfunction in patients with diabetes mellitus.