糖尿病患者实时超声心动图左心室功能指标与血清LPN、NGAL、sfrp5及代谢指标的关系  

Real-time echocardiography assessment of left ventricular function and correlation with serum LPN,NGAL,sfrp5,and metabolic indexes in patients with diabetes mellitus

作　　者：张毓[1] 李亚洲[1] 宋雨[1] 孟凡荣[1] 栗春莉 沈晓丽 宣佶 ZHANG Yu;LI Yazhou;SONG Yu;MENG Fanrong;LI Chunli;SHEN Xiaoli;XUAN Ji(Department of Ultrasound,Nanjing Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210014,Jiangsu,China;General Hospital of Eastern Theater Command,Nanjing 210000,Jiangsu,China)

机构地区：[1]南京中医药大学附属南京市中西医结合医院超声科,江苏南京210014 [2]东部战区总医院,江苏南京210000

出　　处：《贵州医科大学学报》2021年第4期428-435,共8页Journal of Guizhou Medical University

基　　金：国家自然科学基金项目(81704196)。

摘　　要：目的应用实时超声心动图评价糖尿病(DM)患者的左心室功能变化,探讨其与血清瘦素(LPN)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、分泌型卷曲相关蛋白5(sfrp5)及相关代谢指标的关系。方法188例DM患者根据是否合并糖尿病微血管病变(DMIP)分为单纯DM组(n=103)和DMIP组(n=85),另选取同期健康体检者100名作为正常对照组(NC组);比较3组的常规超声心动图和三维实时超声心动图(RT-3DE)参数、容积-时间曲线(VTC)及血清LPN、NGAL、sfrp5、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbAlc)、血肌酐(Scr)、β2-微球蛋白(β2-MG)及胱抑素C(CysC)水平。结果与单纯DM组和NC组比较,DMIP组的左室舒张末期内径(LVEDd)、左房内径(LAD)、室间隔厚度(IVSTd)、左室后壁厚度(LVWTd)、左室心肌质量指数(LVMI)、二维左室舒张末期容积(2DE-EDV)、三维左室舒张末期容积(3DE-EDV)、三维左室收缩末期容积(3DE-ESV)、VTC参数和血清LPN、NGAL、HbALc显著升高,血流E峰和A峰峰值流速比(E/A)、二维左室射血分数(2DE-LVEF)、三维左室射血分数(3DE-LVEF)及血清sfrp5降低(P<0.05);且单纯DM组的3DE-EDV、VTC参数和血清LPN、NGAL、HbAlc显著高于NC组,而3DE-LVEF及血清sfrp5低于NC组(P<0.05);LVMI、3DE-EDV、VTC参数与LPN、NGAL、HbAlc呈正相关性,与sfrp5呈负相关性(P<0.05);3DE-LVEF与LPN、NGAL、HbAlc呈负相关性(P<0.05),而与sfrp5呈正相关性(P<0.05)。结论DM早期即存在左室舒张及收缩功能受损,发生DMIP时这些损害更为严重,且LVMI、3DE-EDV、VTC、3DE-LVEF与患者的HbAlc、LPN、NGAL、sfrp5等水平密切相关。Objective To evaluate the left ventricular function in patients with diabetes mellitus(DM)by real-time echocardiography and to explore its correlation with serum leptin(LPN),neutrophil gelatinase-related lipocalin(NGAL),secreted frizzled-related protein 5(sfrp5)and related metabolic indicators.Methods One hundred and eightyeight cases of DM patients were enrolled and divided into two groups:Simple DM group(n=103)and diabetic microangiopathy(DMIP)group(n=85).100 healthy subjects were enrolled as normal control group(NC group).The onventional echocardiography,real-time three-dimensional echocardiography(RT-3DE)parameters and volume-time curve(VTC)parameters were compared of the three groups,the serum levels of LPN,NGAL,sfrp5,and related metabolic indicators including fasting blood glucose(FBG),2 h postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbAlc),serum creatinine(Scr),β2-microglobulin(β2-MG),cystatin C(CysC)were determined.Results Compared with the DM group and NC group,the left ventricular end-diastolic diameter(LVEDd),left atrium diameter(LAD),interventricular septum thickness(IVSTd),left ventricular posterior wall thickness(LVWTd),left ventricular myocardial mass index(LVMI),two-dimensional left ventricular end-diastolic volume(2DE-EDV),three-dimensional left ventricular end-diastolic volume(3DE-EDV),three-dimensional left ventricular end systolic volume(3DE-ESV),VTC parameters and serum levels of LPN,NGAL and HbAlc in the DMIP group were significantly increased,while ratio of the peak velocity of peak E and peak A(E/A),two-dimensional left ventricular ejection fraction(2DE-LVEF),three-dimensional left ventricular ejection fraction(3DE-LVEF)and serum level of sfrp5 were significantly lower(P<0.05),and the 3DE-EDV,VTC and serum LPN,NGAL,and HbAlc in the DM group were significantly higher than those in the NC group,while the 3DE-LVEFF and serum sfrp5 were significantly lower than the NC group(P<0.05).LVMI,3DE-EDV,VTC parameters were significantly positively correlated with LPN,NGAL,HbAlc,and negat

关 键 词：糖尿病 左心室 超声心动图 代谢 瘦素 蛋白 

分 类 号：R587.1[医药卫生—内分泌]