粘附因子在老年糖尿病性心肌病患者早期诊断中的研究  

The research of adhesion factor in early diagnosis of elderly patients with diabetic cardiomyopathy

作　　者：王晓梅[1] 金涛[1] 俞淑静[1] 郝清顺[1] 

机构地区：[1]枣庄市立医院内分泌科,山东枣庄277100

出　　处：《泰山医学院学报》2015年第11期1205-1207,共3页Journal of Taishan Medical College

摘　　要：目的探讨血管细胞粘附因子-1(VCAM-1)、血清细胞粘附因子-1(ICAM-1)在老年糖尿病性心肌病早期诊断中的价值。方法以老年糖尿病性心肌病(DCM)患者为研究对象,根据有无合并症状性心力衰竭分为有心衰症状组(DCM1组)和无心衰症状组(DCM2组),另外设性别、年龄相匹配的单纯2型糖尿病组(DM组)。所有受试者均检测血清粘附因子VCAM-1、ICAM-1和血浆脑利钠肽(BNP),同时进行超声心动图检查。结果 1与单纯DM组比较,DCM1组和DCM2组VCAM-1、ICAM-1均明显升高,且DCM1组较DCM2组升高有显著性(P<0.05);2DCM1组左室结构各项指标比DCM2组和单纯DM组有明显升高(P<0.05),DCM1组左室功能各项指标比DCM2组和单纯DM组则有明显下降(P<0.05),而DCM2组与单纯DM组间比较,仅舒张功能有显著性差异;3血清VCAM-1、IVAM-1分别与BNP、左房内径(LA)、左室内径(LV)呈正相关,与左室后壁厚度(LVPW)、室间隔厚度(IVS)、射血分数(EF%)、短轴缩短率(FS%)、舒张早晚期充盈峰值流速比值(PVE/PVA)呈负相关(P<0.05或<0.01)。结论粘附因子VCAM-1、ICAM-1与老年糖尿病性心肌病的发生、发展密切相关,可作为老年糖尿病性心肌病早期诊断的指标。Objective： To explore the value of vascular cell adhesion factor-1 （VCAM-1） and cell adhesion factor-1 （ ICAM-1 ） in early diagnosis of elderly patients with diabetic cardiomyopathy. Methods ： The old patients with diabetic car- diomyopathy （DCM） were taken as the research subjects, and according to the presence of merger symptomatic heart failure, they were divided into heart failure symptoms （DCM1 group） and heart failure group （DCM2 group） with no symp- toms, and simple type 2 diabetes mellitus group （DM group） were set up with gender and age matched. Serum adhesion factor VCAM-1, ICAM-1 and plasma brain natriuretic peptide （BNP） were detected in all the subjects, at the same time echocardiography was done to measure the filling velocity peak of early and late diastolic （E, A） in order to calculate E/A ratio, which was used to represent the left ventricular diastolic function; and the ejection fraction （EF） % and short axial shortening rate （FS） % were used＇ to express left ventricular systolic function indexes. Resuhs：①Compared with pure DM group, VCAM-1, ICAM-1 were significantly elevated in DCM1 and DCM2 groups, and compared with DCM1 group, those in DCM2 group increased more obviously （P 〈 0.05 ）. ②Each index of left ventricular structure in DCM1 group signifi- candy increased than that in DCM2 group and pure DM group （P 〈 0.05 ）. Meanwhile each index of left ventricular function in DCM1 group was significantly decreased than that of DCM2 group and pure DM group （ P 〈 0.05 ）. While compared with pure DM group, only diastolic dysfunction had significant difference in DCM2 group. ③VAM-1, VCAM-1 were respectively positively correlated with BNP level, left atrial diameter （LA）, left the interior diameter （LV）, and were nega- tively correlated with left ventricular posterior wall thickness （LVPW）, thickness of interventrieular septum （IVS）, EF, FS, PVE/PVA （ P 〈 0.05 or P 〈 0. 01 ）. Conclusion ： Adhesion factor VCA

关 键 词：糖尿病性心肌病 心力衰竭 粘附因子 早期诊断 

分 类 号：R587.2[医药卫生—内分泌]