代谢综合征患者血管内皮功能与左心室重构关系

目的探讨代谢综合征(MS)患者血管内皮功能与左心室重构情况及两者的相关性。方法选择43名健康人为对照组,92例MS患者分为3组:肥胖及血脂紊乱合并原发性高血压而血糖正常组(MS1组);合并2型糖尿病血压正常组(MS2组);合并原发性高血压和2型糖尿病组(MS3)。使用彩色超声多普勒分别测量血管内皮功能及左心室结构相关参数,分析两者的相关性。结果MS1、MS2、MS3组内皮依赖性血管舒张功能(EDD)较对照组明显降低(P<0.01);MS3组EDD障碍较MS1、MS2组更明显(P<0.05)。MS1、MS2、MS3组舒张末期室间隔厚度、舒张末期左心室后壁厚度、左心室质量、左心室质量指数(LVMI)均明显高于对照组(P<0.05或P<0.01);并且MS2、MS1、MS3的各参数值分别依次增加,3组间差异有统计学意义(P<0.05或P<0.01)。EDD与LVMI呈负相关(偏相关系数为-0.306,P<0.05)。结论MS的危险因素与血管内皮功能紊乱和左心室重构相关。血管内皮功能紊乱与左心室重构有关。

Endothelial dysfunction and its association with left ventricular remodeling in patients with metabolic syndrome

Objective To investigate the endothelial dysfunction and its relationship with left ventricular remodeling in patients with metabolic syndrome(MS).Methods Ninety-two patients with MS and 43 control subjects were recruited for this study.The patients with MS were divided into the following 3 groups,essential hypertension with normal blood glucose(MS1),type 2 diabetes mellitus with normal blood pressure(MS2)and essential hypertension with type 2 diabetes mellitus,obesity and dyslipidemia(MS3).Parameters related to endothelial function and left ventricular structure were measured by echograph.Results Endothelium-dependent dilatation(EDD)in MS1,MS2,MS3 was decreased significantly compared with control subjects(all P<0.01).EDD in MS3 was lower than in MS1 and MS2(P<0.05).Left ventricular posterior wall thickness,interventricular septal thickness,left ventricular mass and left ventricular mass index(LVMI)in MS2,MS1 and MS3 was increased significantly compared with control subjects(P<0.05 or P<0.01),and the parameters mentioned above were increased in the order of MS2,MS1 and MS3 and significant differences were found among MS2,MS1 and MS3(P<0.05 or P<0.01).EDD was negatively related to LVMI(partial correlation coefficient was-0.306,P<0.05).Conclusions MS is related with endothelial dysfunction and left ventricular remodeling,and endothelial dysfunction is related with left ventricular remodeling.