2型糖尿病患者糖化血红蛋白与左室舒张功能的关系  

Study on relationship between level of glycosylated hemoglobin (HbA1c) and left ventricular diastolic function in patients with type 2 diabetes mellitus

作　　者：郭春艳[1] 李虹伟[1] 滕一星[1] 沈潞华[1] 

机构地区：[1]首都医科大学附属北京友谊医院心血管中心,北京100050

出　　处：《临床和实验医学杂志》2014年第19期1598-1600,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的筛选检测糖尿病早期心功能损害的超声心动图敏感指标,且评价血糖控制水平与心功能之间的关系。方法入选56例无心脏及相关疾病的2型糖尿病患者为糖尿病组,同时选取52例年龄、性别相匹配的健康志愿者为对照组。两组患者均行超声心动图常规指标及组织多普勒检查。糖尿病组患者测定糖化血红蛋白(HbA1c)水平。结果两组病例收缩功能指标无显著差异(P>0.05)。糖尿病组二尖瓣舒张晚期峰值流速(A)水平高于对照组(P<0.01),E/A低于对照组(P<0.01),等容舒张期时间(IVRT)较对照组延长(P<0.05)。糖尿病组左室心肌平均舒张早期峰值速度(E')、E'/A'低于对照组(P<0.01),糖尿病组左室心肌平均舒张晚期峰值速度(A')、E/E'高于对照组(P<0.01)。HbA1c与E/A(r=-0.310,P<0.05)、E'(r=-0.409,P<0.01)、E'/A'(r=-0.380,P<0.01)呈负相关,并与E/E'(r=0.488,P<0.01)呈正相关。结论 2型糖尿病患者在收缩功能受损之前即存在舒张功能异常。组织多普勒是检测2型糖尿病患者早期舒张功能异常的有效工具,2型糖尿病患者HbA1c与左室舒张功能的敏感指标E/E'具有明显相关性。Objective To explore the echocardiographic sensitive indexes for prediction of subclinical cardiac dysfunction and to evaluate the relationship between plasma level of glycosylated hemoglobin（HbA1c）and cardiac function. Methods 56 DM2 patients（48.2 ＆#177;7.8 years） without evidence of heart disease and 52 age- and sex-matched normal controls（47. 8 ＆#177; 7. 1 years）were enrolled in this study. Indexes of con-ventional echocardiography,tissue Doppler imaging were measured in both groups. The levels of HbA1c in DM2 patients were determined. Results There was no significant difference in systolic indexes between these two groups（ P 〉0. 05）. Peak late diastolic mitral velocity（A）was higher （ P 〈0. 01）,E/A was lower（ P 〈0. 01）and isovolumetric relaxation time（IVRT）was longer（ P 〈0. 05）in DM group than those of control group. Mean LV myocardial early diastolic velocity Eˊand Eˊ/Aˊwere lower in DM group than those of control group（ P 〈0. 01）. Mean LV myo-cardial late diastolic velocity Aˊand E/Eˊwere higher in DM group than those of control group（ P 〈0. 01）. Level of HbA1c was negatively correla-ted with E/A（ r = -0. 310,P 〈0. 05）,Eˊ（ r = -0. 409,P 〈0. 01）and Eˊ/Aˊ（ r = -0. 380,P 〈0. 01）and positively correlated with E/Eˊ（ r =0. 488,P 〈0. 01）. Conclusion The diastolic dysfunction exists before the damage of systolic function in DM2 patients. Tissue Doppler imaging can be used as sensitive means for early detection of changes of early cardiac function in DM2 patients. Level of HbA1c is related with di-astolic dysfunction.

关 键 词：2型糖尿病 左室舒张功能 组织多普勒 糖化血红蛋白 

分 类 号：R587.1[医药卫生—内分泌]