老年2型糖尿病患者病程及血脂指标与心脏结构及功能改变的相关性  

Correlation between course of disease and serum lipids in elderly patients with type 2 diabetes mellitus and changes in cardiac structure and function

作　　者：赵峰 曹艺明[1] 石雪丽[2] 杨卫京 张红茹[4] ZHAO Feng;CAO Yi-ming;SHI Xue-li(Department of Internal Medicine,Baoding Third Central Hospital,Baoding Hebei 071000,China;Department of Endocrinology,Baoding Third Central Hospital,Baoding Hebei 071000,China)

机构地区：[1]保定市第三中心医院内科,河北保定071000 [2]保定市第三中心医院内分泌科,河北保定071000 [3]保定市第三中心医院老年病科,河北保定071000 [4]保定市妇幼保健院妇产科,河北保定071000

出　　处：《临床和实验医学杂志》2021年第11期1156-1159,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省自然科学基金面上项目(编号:0131674)。

摘　　要：目的探讨老年2型糖尿病患者病程及血脂指标与心脏结构及功能改变的相关性。方法前瞻性选择2019年4月至2020年4月保定市第三中心医院内分泌科确诊并收治的老年2型糖尿病患者85例作为糖尿病组,按照病程不同分为<5年24例,5~10年22例,11~15年20例,>15年19例;选择同时期内健康体检者60名作为对照组。比较不同病程组和对照组血脂指标[低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)]及心脏结构、功能指标[左心房内径(LAD)、左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)、室间隔厚度(LVSd)、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)、二尖瓣口舒张早期血流充盈速度(E)、二尖瓣口舒张晚期血流充盈速度(A)、二尖瓣口舒张早期/晚期血流充盈速度(E/A)],分析病程、血脂指标与心脏结构、功能指标的相关性。结果糖尿病组E、E/A、HDL-C值低于对照组,而A、LDL-C、TG值高于对照组,差异均有统计学意义(P<0.05);LAD、LVEDd、LVESd、LVSd、LVEF、LVFS、TC值比较,差异均无统计学意义(P>0.05)。不同病程组LAD、LVEDd、LVESd、LVSd、LVEF、LVFS、E、TG、TC值比较,差异均无统计学意义(P>0.05);病程<5年组、5~10年组、11~15年组、>15年组,E/A、HDL-C值依次减低,A、LDL-C值依次增加,组内两两比较差异均有统计学意义(P<0.05)。LVSd改变、E/A<1与病程、HDL-C呈负相关,与LDL-C呈正相关(P<0.05)。病程增加、LDL-C≥2.30 mmol/L、HDL-C<2.30 mmol/L是心脏结构、舒张功能异常高危因素(P<0.05)。结论老年2型糖尿病患者病程增加及血脂指标LDL-C、HDL-C的变化与心脏结构及功能异常密切相关。Objective To investigate the correlation between the course of disease and serum lipids in elderly patients with type 2 diabetes mellitus and the changes in cardiac structure and function.Methods From April 2019 to April 2020,85 elderly patients with type 2 diabetes who were diagnosed and admitted to the Department of Endocrinology,Baoding Third Central Hospital were prospectively selected as the diabetes group,including 24 patients with disease course<5 years,22 patients with disease course ranging from 5 to 10 years,20 patients with disease duration ranging from 11 to 15 years,and 19 patients with disease course>15 years.Another 60 healthy individuals were also enrolled as the control group.Then comparison was performed among various indexes,including blood lipid indicators[low-density lipoprotein cholesterol(LDL-C),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),total cholesterol(TC)]and cardiac structure and function indicators[left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd),ventricular septal thickness(LVSd),left ventricular ejection fraction(LVEF),left ventricular fraction shortening(LVFS),peak flow velocity of early diastole during atrial contraction(E),peak flow velocity of late diastole during atrial contraction(A),E/A].the course of disease,blood lipid indicators and cardiac structure,functional indicators were aralyzed.Results The values of E,E/A and HDL-C in the diabetic group were lower than those in the control group,while the values of A,LDL-C and TG in the diabetic group were higher than those in the control group,the differences were statistically significant(P<0.05);there were no significant differences in LAD,LVEDd,LVESD,LVSD,LVEF,LVFS and TC(P>0.05).There were no significant differences in LAD,LVEDd,LVESD,LVSD,LVEF,LVFS,E,TG and TC among different course groups(P>0.05);the E/A and HDL-C values decreased in the<5 years group,5-10 years group,11-15 years group and>15 years group,while the A and LDL-C values incr

关 键 词：老年2型糖尿病 病程 血脂指标 心脏结构 功能改变 

分 类 号：R587.1[医药卫生—内分泌]