2型糖尿病早期肾损害与心室重构的关系  

Relationship between mild renal dysfunction and ventricle remodeling in patients with diabetes mellitus

作　　者：秦春梅[1] 刘波[1] 尹福在[1] 陆强[1] 马春明[1] 吴广飞[1] 

机构地区：[1]秦皇岛市第一医院,河北秦皇岛066000

出　　处：《山东医药》2011年第37期10-12,共3页Shandong Medical Journal

基　　金：秦皇岛市科学技术研究与发展指导计划项目(2007028)

摘　　要：目的探讨2型糖尿病患者早期肾损害与心室重构的关系。方法选择2型糖尿病患者136例,根据24 h尿微量白蛋白(UMA)分为糖尿病组(DM组,UMA定量<30 mg/24 h)、微量白蛋白尿组(早期DN组,UMA定量30～300 mg/24 h),同期选取健康体检者90例作为对照组。分别观察各组患者血、尿等生化指标,采用彩色多普勒超声诊断仪测量舒张期末左室内径(LVD)、舒张期末左室后壁厚度(LVPW)、舒张期末室间隔厚度(IVS),并对影响左室结构的危险因素进行相关分析。结果三组间LVD、IVS、相对室壁厚度(RWT)比较差异无统计学意义。DM组、早期DN组LVPW、左室质量(LVM)、左室质量指数(LVMI)高于对照组(P均<0.05),且早期DN组LVPW、左室质量(LVM)、LVMI高于DM组(P均<0.05)。早DN组LVH发生率(11.864%)高于DM组(1.298%)及对照组(P均<0.05)。多元线性回归分析显示,UMA、年龄为LVMI升高的独立危险因素。结论糖尿病早期肾损害者更易发生心室重构,UMA是心室重构的独立危险因子。Objective To investigate the characteristics of renal dysfunction in the DM subjects and its role in left ventricle remodeling. Methods One hundred and thirty-six cases with T2DM were selected and divided into two groups according to the level of microalbuminuria： non-diabetic nephropathy group（DM group）, mild diabetic nephropathy group （DN group）. Ninety healthy subjects were admitted in control group. All patients were collected fasting venous blood to assay biochemical indicator. Patients were observed by color doppler echocardiography with left ventricular diastole period end point,left ventricle inner diameter （LVD）, left ventricular posterior wall thickness （LVPW） and interventricular septum thickness （IVS） were measured, and analyzed the influence factors of left ventricle. Results Among control group, DM group and DN group, there was no significant deference in LVD、 IVS、 RWT. LVPW, LVM, LVMI in DN group, DM group were higher than those in control group（all P〈0.05）, and those indexes in DN group higher than those in DM group（all P〈0.05）. In DM group, the prevalence of LVH in DN group（11.864% ）was higher than that in DN group （1.298%）. Multivariable logistic regression analysis revealed that UMA, age were the independent danger factors of LVMI. Conclusions Ventricle remodeling exist in the patients with early diabetic renal dysfunction. Uric microalbum is a dependent factor in prediction of LVD remodeling.

关 键 词：糖尿病 肾功能衰竭 心室复建 

分 类 号：R587.1[医药卫生—内分泌]