亚临床糖尿病心肌病患者微量白蛋白尿与心功能相关性  

The Correlation between Microalbuminuria and Leftventricular Function in Type 2 Diabetics with Subclinical Diabetic Cardiomyopathy

作　　者：郑和昕[1] 吴天凤[1] 袁放[1] 江缨[1] 俞晓映[1] 叶萌[1] 俞蔚[1] 

机构地区：[1]浙江医院,浙江杭州310013

出　　处：《心脑血管病防治》2011年第1期12-14,0-1+0,共3页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：浙江省老年医学重点学科资助项目2007ZB012

摘　　要：目的:探讨亚临床糖尿病心肌病患者微量白蛋白尿与Tei指数及其他传统左心室收缩舒张功能指标的相关性。方法:采用彩色多普勒超声诊断仪对正常对照组、2型糖尿病组、2型糖尿病亚临床心肌病伴微量白蛋白尿组及不伴微量白蛋白尿组进行Tei指数和其他左心室收缩舒张功能指标的测定,评估不同尿白蛋白肌酐比值(ACR)与Tei指数等心功能指标的相关性。结果:随着ACR增加,Tei指数呈逐渐增加趋势,E峰减速时间(DT)呈逐渐延长趋势。在控制体质指数(BMI)、血压、血糖、血脂水平后,ACR与Tei指数呈独立正相关,与DT呈独立负相关。结论:亚临床糖尿病心肌病患者从正常尿白蛋白向微量白蛋白尿进展,首先出现左心室舒张功能逐渐减退。Tei指数与DT甚至在2型糖尿病正常白蛋白即已出现变化,可为2型糖尿病亚临床心肌病早期诊治提供依据。Objective To explore the correlation between microalbuminuria and leftventricular function in type 2 diabetics with subclinical diabetic cardiomyopathy.Methods 30 normal healthy controls,33 type 2 diabetic controls,34 patients with subclinical type 2 diabetic cardiomyopathy without albuminuria and 33 subclinical type 2 diabetic cardiomyopathy with microalbuminuria were enrolled in this study.The Doppler echocardiography was used to assess left ventricular Tei index and other systolic and diastolic function.The correlation between ACR and left ventricular Tei index and other systolic and diastolic function was evaluated.Results With ACR＇s increasing,Tei index was gradually increased,E wave decreasing time（DT） was gradually elongated.After controlling the BMI,blood pressure,blood glucose and blood cholesteroid levels,ACR was indepently positively related to Tei index and negatively related to DT.Conclusions In type 2 diabetics with subclinical diabetic cardiomyopathy,during the period from normal albuminuria to microalbuminuria,left ventricular diastolic function deteriorated firstly.Tei index and DT were changed even before microalbuminuria,and both could serve as predictors for early diagnosis and intervention in type 2 diabetics with subclinical diabetic cardiomyopathy.

关 键 词：2型糖尿病 亚临床心肌病 微量白蛋白尿 左室TEI指数 

分 类 号：R587.1[医药卫生—内分泌] R542.2[医药卫生—内科学]