2型糖尿病左室舒张功能及与内皮素和降钙素基因相关肽的关系  

Correlation between left ventricular diastolic function and endothelium and calcitonin gene-related peptide in patients of type 2 diabetes mellitus

作　　者：孙红丽[1] 石昌红[2] 景斐[1] 李秀昌[2] 方永奇[1] 

机构地区：[1]泰山医学院,山东泰安271016 [2]泰山医学院附属医院,山东泰安271000

出　　处：《泰山医学院学报》2008年第1期8-10,共3页Journal of Taishan Medical College

摘　　要：目的应用超声技术评价2型糖尿病左室舒张功能,并探讨其与内皮素和降钙素基因相关肽的关系。方法20例对照者,48例2型糖尿病患者均行常规超声及多普勒组织成像技术(doppler tissue imaging,DTI)检查。48例糖尿病患者均符合1997年美国糖尿病协会(ADA)关于糖尿病的诊断标准,并除外高血压、冠心病、肝肾功能不全及其他器质性心肺疾病。脉冲波多普勒超声测量二尖瓣血流,根据二尖瓣瓣尖频谱测量舒张早期最大血流速度(E0)、晚期最大血流速度(A)及其比值(E0/A)。DTI测量二尖瓣环心肌舒张早期峰值运动速度(e)、晚期峰值运动速度(a)及其比值(e/a)。所有研究对象均用放射免疫分析测定血浆内皮素和降钙素基因相关肽的浓度。结果与对照组相比,糖尿病组二尖瓣瓣尖舒张早期、晚期最大血流速度比值减小(对照组E0/A比值:1.34±0.12,糖尿病组E0/A比值:0.81±0.13,P<0.001);与对照组相比,糖尿病组二尖瓣侧环e/a比值减小(对照组e/a比值:1.38±0.15,糖尿病组e/a比值:0.84±0.17,P<0.001)。与对照组相比,糖尿病组内皮素浓度升高(对照组:0.36±0.07 ng/ml,糖尿病组:0.56±0.09 ng/ml,P<0.001),降钙素基因相关肽浓度降低(对照组:104.4±11.37ng/ml,糖尿病组:70.57±8.53 ng/ml,P<0.001);内皮素与E0/A、侧环e/a负相关(r分别为-0.44、-0.56,P均<0.01),降钙素基因相关肽与E0/A、侧环e/a正相关(r分别为0.45、0.62,P均<0.01)。结论应用超声技术评价的糖尿病左室舒张功能与内皮素和降钙素基因相关肽有较好的相关性。Objective： To detect the correlation between left ventricular diastolic function and endothelium and calcitonin gene-related peptide.Methods： Forty-eight patients with type 2 diabetes mellitus were all diagnosed by the ADA standard in 1997,excluding hypertension,coronary heart disease,kidney and liver dysfunction and other organic cardio-pulmonary deaseases.Twenty normal subjects and 48 patients with 2 diabetes mellitus were studied by echocardiography.The pulsed Doppler was used to measure the flow speed of early diastolic period（E0） and the flow speed of late diastolic period（A） at mitral tip ,E0A ratio was caculated.We detected wall motion of mitral valve annulus and recorded TDI indexes including e,a,e/a ratio.The plasma concentration of endothelium and calcitonin gene-related peptide was measured by radio-immunology analysis.Results：（1） In 2 diabetes mellitus group,the flow speed ratio of early diastolic period to late diastolic period in the apex of mitral valve decreased （control group E0A ratio =1.34±0.12,DM group： 0.81±0.13,P〈0.001）.（2） Compared with control group,e/a ratio decreased in 2 diabetes mellitus group （control group：1.38±0.15,DM group： 0.84±0.17,P〈0.001）.（3） Compared with control group,endothelium increased in 2 diabetes mellitus group（control group： 0.36±0.07 ng/ml,DM group： 0.56±0.09 ng/ml,P〈0.001）.（4） Compared with control group,calcitonin gene-related peptide decreased in 2 diabetes mellitus group（control group：104.4±11.37 ng/ml,DM group： 70.57±8.53 ng/ml,P〈0.001）.（5） Endothelium was negatively correlated withE0A ratio and e/a ratio （r=-0.44,-0.56,P均〈0.01）;calcitonin gene-related peptide was positively correlated withE0A ratio and e/a ratio（r=0.45,0.62,P均〈0.01）.Conclusion： Endothelium and calcitonin gene-related peptide had good interrelation with left ventricular diastolic function by echocardiography.

关 键 词：内皮素 降钙素基因相关肽 心室功能 糖尿病/病理生理学 超声心动描记术 

分 类 号：R587.1[医药卫生—内分泌]