原发性高血压、2型糖尿病患者心肌收缩力受损差别及影响因素探讨  

Different of myocardium contractility injury and affecting factors in patients with essential hypertension and type 2 diabetes mellius

作　　者：刘璟瑜[1] 何辉[1] 罗永芬[1] 李艳[1] 曾朝荣[1] 任艳[2] 

机构地区：[1]成都市第七人民医院,四川成都610021 [2]四川大学华西医院内分泌科,四川成都610041

出　　处：《中国心血管杂志》2006年第2期127-130,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的探讨原发性高血压(EH)、2型糖尿病(T2DM)、EH合并T2DM(EH+T2DM)患者心肌收缩力受损害的差别及部分影响因素。方法采用超声心动图(UCG)评价24例健康者、49例EH、20例T2DM和21例EH+T2DM患者的左心室壁内缩短分数(MFS)及应力相关MFS(S-cMFS),并同时检测糖化血红蛋白A1c(HbA1c)、血糖(GL)、24h尿总蛋白(TuA)、微量蛋白(MuA)、肾功能和血脂。结果与正常组比较,EH、T2DM和EH+T2DM组MFS和S-cMFS明显减少,T2DM和EH+T2DM组更为明显;单变量相关分析显示HbA1c、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)与MFS和S-cMFS呈显著相关,MuA与MFS呈显著负相关;多变量相关分析提示仅MuA和HbA1c与MFS显著相关,HbA1c与S-cMFS显著相关。结论EH、T2DM和EH+T2DM患者心肌收缩力明显损害,尤以EH+T2DM患者更显著,HbA1c和MuA是损害心肌收缩力的重要因素,TC、TG、LDL也可能具有不良影响。Objective To explore the different of myocardium contractility injury and affecting factors in patients with essential hypertension（EH）a nd type 2 diabetes mellius（T2DM） or both type 2 diabetes and hypertension（ T2DM ＋ EH）. Methods The left ventricular midwall fractional shortening（ MFS） and stress-corrected MFS（ S-cMFS） were assessed by Doppler ecbocardiography, at the same time, HbA1c, blood glucose （ GL）, total urinary albuminuria （ TuA ） and urinary microalbumin of 24 hours（MuA）, renal function（blood urea,creatinine） and total cholesterol（TC）, triglyceride（TG）, low density lipoprotein-cholesterol（ LDL） were measured in 24 cases of normal subjects,49cases of EH, 20 cases of T2DM and 21 cases of T2DM ＋ EH. Results MFS and S-cMFS in EH, T2DM and T2DM ＋ EH patient groups ,especially in T2DM and T2DM ＋ EH patient groups were decreased significantly compared with normal group. Univariate correlation anal）isis showed that HbA1c, TC, TG and LDLwere negatively correlated with MFS and S-cMFS. MuA was negatively correlated with MFS. Multivariate correlation analysis indicated that only MuA and HbAlc were positively related to MFS, HbAlc were related to S-cMFS. Conclusion the myocardium contractility in significantly damaged in EH, T2DM, and T2DM ＋ EH patients groups, especially the T2DM ＋ EH patients group. HbAlc and MuA are the two of important factors for myocardium contractility injury. Maybe, TC,TG and LDL have the harm for affection.

关 键 词：高血压 2型糖尿病 室壁内缩短分数 影响因素 

分 类 号：R544.1[医药卫生—心血管疾病] R587.1[医药卫生—内科学]