186例糖尿病性心脏病的临床分析

目的:探讨糖尿病性心脏病(DC)的危险因素及其临床表现。方法:收集我院2009年1月～2012年6月收治的糖尿病565例,其中DC患者186例。应用回顾性研究方法分析糖尿病性心脏病的临床表现和治疗;并根据是否伴发心脏疾病将糖尿病患者分为单纯糖尿病组和糖尿病性心脏病组,探讨糖尿病性心脏病的相关危险因素。结果:未用降糖药或胰岛素、未控制饮食、BMI≥24、糖化血红蛋白(HbA1C)≥9.0%、合并高血压和糖尿病史≥5年是糖尿病性心脏病的危险因素。186例DC中,高血压占91.40%,心肌梗死占22.04%,心律失常占48.92%,心脏扩大占31.18%。41例心肌梗死中,有心绞痛史占65.85%,无痛性心肌梗死占34.15%。心源性猝死占3.76%。结论:控制血糖、血压、血脂、体重及改变生活方式,减少合并症是防止糖尿病性心脏病发生发展的关键。

Clinical Analysis on 186 Cases of Diabetic Cardiomyopathy

Objective：To investigate the risk factors of diabetic cardiomyopathy （DC） and its clinical manifestation s.Methods：Collected the 565 cases of diabetes treated in our hospital from January 2009 to June 2012,including the 186 cases of DC Analyzed the clinical manifestations and treatment of diabetic cardiomyopathy by using the method of retrospective study,moreover separated diabetes into simple diabetes group and DC group according to whether associated with heart disease or not,in order to investigate the risk factors of DC.Result：Taking no hypoglycemic agents,uncontrolled eating,BMI ≥24,glycosylated hemoglobin （HbA1C）≥9.0%,history of hypertension and diabetes more than five years were the risk factors of diabetic cardiomyopathy.In 186 cases of DC,Hypertension accounted for 91.40%,myocardial infarction was 22.04%,Arrhythmia was 48.92%,and enlargement of the heart was 31.18%.In 41 cases of myocardial infarction,Angina pectoris accounted for 65.85%,painless myocardial infarction was 34.15%.Sudden cardiac death accounted for 3.76%.Conclusion：Control blood sugar,blood pressure,blood lipids,hypercoagulability,weight,lifestyle changes and reduce the complications is the key to prevent the development of diabetic cardiomyopathy.