糖尿病患者左心室舒张功能与动脉僵硬度的相关性研究  

The relationship between left ventricular diastolic function and arterial stiffness of diabetes patients

作　　者：田国祥[1] 张薇[1] 武云涛[1] 王玉言[1] 魏万林[1] 

机构地区：[1]北京军区总医院干四科,100700

出　　处：《中国综合临床》2014年第7期678-680,共3页Clinical Medicine of China

基　　金：全军医学科研计划项目（CWS12J059）

摘　　要：目的：探讨2型糖尿病患者左心室舒张功能与动脉僵硬度的相关性。方法选取2012年1月至2013年12月在北京军区总医院住院治疗的2型糖尿病患者102例（糖尿病组），同期住院治疗的非糖尿病患者126例作为对照组。采集入组患者的病史并检测血脂、血糖等生化指标，采用 VS-1000动脉硬化检测仪测定心踝血管指数（ CAVI），超声心动图测定左心室舒张功能指标，包括左心房内径（LAD）、左心室舒张早期流速峰值（ E）、左心室舒张晚期流速峰值（ A）、E/ A 比值及 E 峰减速时间（EDT）。比较两组患者左心室舒张功能、CAVI 水平等指标的差异并进行相关性分析。结果糖尿病组患者 LAD、A、EDT、CAVI 水平显著高于对照组[LAD 分别为[（39.5±5.3）mm 与（34.4±4.2）mm；A 分别为（76.6±13.5）cm/ s 与（71.3±13.4）cm/ s；EDT 分别为（206.6±56.3）ms 与（185.5±34.4）ms；CAVI 分别为9.6±1.1与8.5±0.9]；而 E、E/ A 水平显著低于对照组[E 分别为[（56.6±20.4）cm/ s 与（67.5±16.4）cm/ s；E/ A 分别为0.73±0.21与0.96±0.26]，两组比较差异均有统计学意义（P 值分别为0.001、0.004、0.002、0.001、0.001、0.001）。在校正了体质量指数、甘油三酯等相关因素后 CAVI 仍与E/ A 呈负相关（r =-0.339，P ＜0.05），与 EDT 呈正相关（r =0.314，P ＜0.05）。结论糖尿病患者心脏舒张功能减低，动脉僵硬度增加，两者呈负相关。Objective To investigate the association between left ventricular diastolic function and arterial stiffness in patients with type 2 diabetes mellitus. Methods One hundred and two patients with type 2 diabetes（ diabetic group）,and 126 non-diabetic patients（ control group） were selected from Jan. 2012 to Dec. 2013 in the Beijing Military General Hospital. The clinical features were recorded and free blood glucose （FBG ）,blood lipids were measured. Cardio ankle vascular index（ CAVI ） was measured by VS-1000 arteriosclerosis detector. Ultrasound heartbeat diagram was used to determine the left ventricular diastolic function indexes including the left atrial diameter（LAD）,left ventricular early diastolicpeak velocity（E）,left ventricular diastolic peak velocity（A）,E/ A ratio and E peak deceleration time（EDT）. Results The level of LAD,A, EDT,CAVI in diabetic patients were（39. 5 ± 5. 3）mm,（76. 6 ± 13. 5）cm/ s,（206. 6 ± 56. 3）ms,（9. 6 ± 1. 1）respectively,higher than those in control group（（34. 4 ± 4. 2）mm,（71. 3 ± 13. 4）cm/ s,（185. 5 ± 34. 4）ms,（8. 5 ± 0. 9））. And E,E/ A level in diabetic group were（56. 6 ± 20. 4）cm/ s and（0. 73 ± 0. 21）,significantly lower than the control group（（67. 5 ± 16. 4）cm/ s and（0. 96 ± 0. 26））. The differences between the two groups were significant（P = 0. 001,0. 004,0. 002,0. 001,0. 001,0. 001）. After adjusting the factors including body mass index and triglyceride,CAVI was negatively correlated with E/ A（r = - 0. 339,P〈 0. 05））and positively correlated with EDT（r = 0. 314,P 〈 0. 05）. Conclusion The diabetic patients with lower diastolic function and higher arterial stiffness,and the two factors are negatively correlation.

关 键 词：糖尿病 心脏舒张功能 动脉僵硬度 心踝血管指数 

分 类 号：R587.1[医药卫生—内分泌]