空腹血糖受损切点下调后不同血糖水平对心脏结构及左室功能的影响  

The Influnce of Different Level of Fasting Plasma Glucose on Left Ventricular Structure and Function by Echocardiography After Lowering the Cutoff Value of Impaired Fasting Glucose

作　　者：王全江[1] 张煜华[1] 孙延河 李茹[1] 韩宗耀[1] 陈正雷[1] 

机构地区：[1]郑州市第三人民医院超声科,郑州市450000 [2]检验科

出　　处：《中国超声医学杂志》2013年第11期987-990,共4页Chinese Journal of Ultrasound in Medicine

基　　金：郑州市2010年度科技攻关项目(No.2010SFXM175)

摘　　要：目的探讨空腹血糖受损切点下调后不同空腹血糖水平对心脏结构及左室功能的影响。方法将研究对象按照血糖水平分为4组:A组(血糖正常组)25例,B组(新增空腹血糖受损组)22例,C组(糖尿病前期组)22例,D组(2型糖尿病组)31例。均经测定空腹血脂、空腹血糖(FBG)及负荷后2 h血糖(2 h FBG)、糖化血红蛋白(HbA1c)等。超声心动图常规观察心脏结构并测定房室大小、左室收缩和舒张功能等指标。结果与A组对比,C组与D组的体左室心肌质量(LVM)、左室心肌质量指数(LVMI)均增高(P<0.05);左室收缩功能指标中,室壁中层缩短率(mFS)、二尖瓣环收缩期的峰速度(Sm)均降低(P<0.05);左室射血分数(EF)、缩短分数(FS)无显著差异(P>0.05);左室舒张功能指标中,二尖瓣环舒张期的峰速度(Em)、Em/Am及E/Em均显著降低(P<0.05)。无论收缩功能指标,还是舒张功能指标,B组都有一定程度的降低,但差异不显著(P>0.05)。结论糖尿病前期组已经发生了心脏重构和左室功能降低,新增空腹血糖受损组心脏结构和左室功能变化不明显。Objective To investigate the influnce of different levels of fasting plasma glucose on left ventricular structure and function after lowering the cutoff value of impaired fasting glucose. Methods All the patients were di- vided into 4 groups according to their plasma glucose levels： A Normal plasma glucose group;B Newly categorized im- paired fasting glucose group;C Pre-diabetes group;D Type 2 Diabetes group. The biochemical indexes were determined with total automatic biochemistry analyzer, fasting plasma glucose and 2 hour postprandial glucose with the oxidase method. Echocardiography was performed in all the patients, The echocardiographic parameters analyzed including left ventricular structure, left atrial diameter, LV systolic and diastolic function. Results Compared to normal group, left ventricular mass and left ventricular mass index were markedly higher, but mFS, Sm,Em,Em/Am and E/Era were decreased significantly in group C and group D except EF and FS. However, no statistically significant difference was found in LV function between group B and group A（P2〉0. 05）. Conclusions There is the same left ventricular remod- eling and function decreasing in pre-diabetes as in type 2 diabetes, left ventricular structure and function have not changed significantly in newly categorized impaired fasting glucose patients.

关 键 词：空腹血糖受损 糖尿病前期 超声心动图 心脏结构 左室功能 

分 类 号：R587.1[医药卫生—内分泌]