基于心脏-血管弹性匹配探讨Ⅱ型糖尿病患者心血管功能变化  

Arterial-ventricular Stiffness Matching:Insights Into Cardiovascular Performance in Patients with Type 2 Diabetes Mellitus

作　　者：李朝军[1] 康春松[1] 史凯玲[1] 薛继平[1] 

机构地区：[1]山西医学科学院.山西大医院超声科,太原市030032

出　　处：《中国超声医学杂志》2013年第3期231-235,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的初步探讨糖尿病患者心功能与全身动脉功能间的匹配关系。方法对Ⅱ型糖尿病患者依据左心室射血分数(EF)分组:选取EF正常组(DMN组)40例,EF减低组(DMA组)40例共80例,另选42例为正常对照组。测量和计算左室舒张末容积(LVEDV)、收缩末容积(LVESV)、左室壁相对厚度(RWT)和左室质量(LVMI),计算EF、心排量(CO)、心脏指数(CI),做功参数(SW)和心肌耗氧参数(RPP),计算体循环血管阻力指数(SVRI)、有效动脉弹性(Ea)。采用多元线性逐步回归,筛选Ea的独立关联指标。结果 (1)DMN和DMA组甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)和空腹血糖(FPG)增高(P<0.05、P<0.01);RWT、LVMI在3组间差异有统计学意义(P<0.01);DMA组LVEDV、LVESV、EF、CI、RPP及SW与DMN组和对照组比较差异有统计学意义(P<0.01)。(2)Ea和SVRI在3组间差异均有统计学意义(P<0.05、P<0.01)。(3)Ea与RPP、SW、HDL-C和FPG及RWT和EF高度关联。结论Ⅱ型糖尿病患心脏-血管功能间存在耦联关系。心脏结构、功能状态和血生化指标独立影响外周动脉。Objective To preliminarily investigate the matching relationship between cardiac and arterial function in patients with type 2 diabetes mellitus （T2DM）. Methods Eighty of patients with T2DM were divided into two groups： group DMN （40 cases） who were normal ventricular systolic function and ejection fraction （EF） of left ven- tricular, and group DMA （40 cases） who were cardiac insufficiency. The 42 cases was control group. The parameters of structure （left ventricular end-diastolic volume, LVEDV, left ventricular end systolic volume, LVESV, relative wall thickness, RWT and left ventricular mass index, LVMI ）, function （EF; cardiac output, COl and cardiac index, CI）, doing work （stroke work, SW） and consumption of myocardium oxygen （rate pressure product, RPP） of left ventricle were measured and calculated. The pressure of left brachial artery was measured and the arterial elastance in- dex （Ea） was calculated. Systemic vascular resistance index （SVRI） was also calculated. The indicators associated with Ea were selected by multiple linear stepwise regressions. Results （1） Level of TG, LDL-C and FPG in T2DM group were higher than control group（P〈0.05, P〈0.01）. There were significant differences in RWT and LVMI a- mong three groups（P〈0.01）. There were significant differences in LVEDV, LVESV, SV, EF, CI, RPP and SW between group DMA and group DMN, control group（P〈0.01）. （2）There were significant differences in Ea and SVRI among three groups（P〈0.05, P〈0.01）. （3）Multiple linear regression showed that RPP, SW, HDL-C, RWI and EF were main factors of Ea. Conclusions Arterial and ventricular function was coupled each other in patients with T2DM. Ventricular structure, function and blood biochemical indicators were independent effect on peripheral arteries.

关 键 词：超声心动描记技术 Ⅱ型糖尿病 心功能 心脏-血管耦联 

分 类 号：R587.2[医药卫生—内分泌] R445.1[医药卫生—内科学]