老年人2型糖尿病患者血糖波动与心脏功能的关系  

The association between glucose fluctuation and cardiac function in the aged patients with type 2 diabetes mellitus

作　　者：孙贇[1] 盛净[1] 蔡文玮[1] 马绍骏[1] 

机构地区：[1]上海交通大学附属第九人民医院老年科,上海200011

出　　处：《中国临床保健杂志》2011年第1期8-10,共3页Chinese Journal of Clinical Healthcare

摘　　要：目的探讨老年人2型糖尿病患者血糖波动状态对心功能的影响。方法选取88例老年人2型糖尿病患者,采用动态血糖监测系统(CGMS)进行72 h连续血糖监测,并按照血糖波动系数(BGFC)分为C组(BGFC≤1.5)、SD1组(1.5<BGFC<3.0)和BGFC两组(BGFC≥3.0),再行二维超声心动图(2D)检查、测量心脏结构与功能指标,分析组间各项指标参数的差异。结果 (1)不同BGFC分组在比较24 h平均血糖、高血糖时间比、平均血糖波动幅度、餐后血糖波动幅度水平方面经秩和检验,均差异有统计学意义(P<0.01),BGFC与上述CGMS参数指标存在着显著正相关(P<0.01);(2)不同BGFC分组,在比较左心房内径、舒张末期左室内径、收缩末期左室内径、室间隔、左室后壁厚度、左室质量水平方面差异有统计学意义(P<0.01);在比较左心室收缩功能(如每搏量、短轴收缩率、左室射血分数)水平方面差异有统计学意义(P<0.05),在比较心室舒张功能(E/A比值)水平方面差异有统计学意义(P<0.05)。结论老年人2型糖尿病患者血糖波动性的增加,将加重心脏结构的损害和功能的下降,需重视动态血糖监测。Objective To explore the relationship between glucose fluctuation and cardiac function in patients with type 2 diabetes mellitus.Methods 88 elderly diabetes mellitus patients,who were measured by continuous glucose monitoring system（CGMS）for 3 days,were divided into C group（BGFC≤1.5）,SD1 group（1.5BGFC3.0）and SD2 group（BGFC≥3.0）by blood glucose wavy coefficient（BGFC）in different levels.Echocardiography was performed in all of these patients to measure the cardiac structure and function.The investigations for the association between BGFC and cardiac function parameters were carried out.Results（1）There were significant differences in the mean level of 24hours blood glucose,the percentage of high glycemic time,the mean level of glucose fluctuation and the mean level of postprandial glucose fluctuation among these three groups（P〈0.01）.BGFC was significantly positively correlated with all the four parameters of CGMS above（P〈0.01）.（2）There were significant differences in LAD,LVDEd,LVDEs,IVS,LVPW and LVM among the three groups（P〈0.05）.There were also significant differences in left ventricular systolic function（such index as SV,FS,EF）and left ventricular diastolic function（E/A ratio）among the groups of（P〈0.05）.Conclusion Our findings indicate that the increasing glucose fluctuation may damage cardiac structure and the cardiac dysfunction in diabetes mellitus patients,and more attention should be paid to CGMS.

关 键 词：糖尿病 2型 血糖指数 肺功能试验 老年人 

分 类 号：R587.1[医药卫生—内分泌]