老年糖尿病患者心脏病变特点及相关危险因素分析  

The cardiopathic features and analysis of risk factors in the elderly diabetic patients

作　　者：吴绮楠[1] 邓武权[1] 王富华[1] 艾智华[1] 刘颖[1] 梁自文[1] 陈兵[1] 

机构地区：[1]第三军医大学第一附属医院内分泌科,重庆400038

出　　处：《中国老年学杂志》2009年第24期3179-3181,共3页Chinese Journal of Gerontology

基　　金：国家"十一五"攻关课题(No.2006BAI02B08)

摘　　要：目的探讨老年糖尿病患者心脏病变的相关危险因素。方法住院的糖尿病患者274例,根据年龄分为A组(<60岁,94例)和B组(≥60岁,180岁)。记录两组患者的身高、体重、血糖、血脂、血压、病程、射血分数(EF)、左心室缩短分数(FS)、舒张末期左室内径、舒张末期室间隔厚度和左室后壁厚度,计算左室质量指数(LVMI)和相对室壁厚度(RWT)及超敏C反应蛋白(hs-CRP)和肿瘤坏死因子-α(TNF-α)。多元线性回归分析年龄与各阳性指标之间的相关性。结果两组身高、体重、空腹血糖、血脂、血压、EF和FS无显著差异;B组LVMI、RWT、超敏C反应蛋白和TNF-α均较A组明显增高(P<0.05);多元线性回归分析提示年龄、病程、超敏C反应蛋白、TNF-α与糖尿病患者RWT、LVMI密切相关。结论超敏C反应蛋白和TNF-α可有效的在早期预警糖尿病心脏病变的病理改变过程。Objective To investigate the cardiac condition of the diabetic patients and to seek for the new diagnostic method of warning its cardiovascular complications in early times. Methods 274 diabetic patients from January in 2004 to July in 2008 were divided into group A （94 patients aged 31 -59） and group B （180 patients aged 60 -90）. The height, weight, blood pressure, lipid of patients were recorded, the ejection fraction （EF）, fractional shortening（FS） , diameter of left ventricle in late diastolic stage （LVEDd）, the thickness of the ventricular septa（IVSD） and the posterior wall of the right ventricle in late diastolic stage （LVPWd） were recorded. Left ventricular mass index （LVMI） , relative wall thickness （RWT） were calculated. High-sensitive C-reactive protein （hs-CRP） and TNF-α were recorded. Multifactor linear regression analysis was made based on the comparison and contrast between all indexes to analyze the correlations between LVMI, RWT and the positive indexes. Results There were no obvious differences of the height, weight, blood glucose, lipid, blood pressure, EF, FS between the two groups. However, the levels of LVMI, RWT, hs-CRP and TNF-α in group A were lower than those in group B（ P 〈 0. 05 ）. According to the results of multifactor linear regression analysis, age, course of disease, hs-CRP and TNF-α were closely related to LVMI and RWT. Conclusions The diabetic patients are susceptive to cardiac hypertrophy with the increasing of the age. The specific change of LVMI and RWT are increased, hs-CRP and TNF-α detection may effectively make a warning of this pathological process in early times.

关 键 词：糖尿病 超声心动图 超敏C反应蛋白 肿瘤坏死因子Α 

分 类 号：R587.1[医药卫生—内分泌]