糖尿病对老年高血压患者心脏结构的影响

目的探讨糖尿病对老年高血压患者心脏结构的影响。方法将351例60岁以上的住院患者分为3组，即单纯高血压（EH）组149例，高血压合并2型糖尿病（T2DM）组129例和对照组73例，依据超声心动图结果评价心脏的结构。结果与单纯EH组比较，EH＋T2DM组的舒张末期左心室内径（LVD）、左室质量（LVM）、左室质量指数（LVMI）明显升高（P〈0．01）。EH＋T2DM组、EH组和对照组左室肥厚（LVH）的发生率分别为48．1％、34．9％和17．8％（P〈0．05／〈0．01）。EH＋T2DM组正常左室几何构型（NG）的比例低于EH组和对照组（44．2％vs56．4％vs82．2％．P〈0．05和〈0．01）；EH＋T2DM组离心性肥厚（ECH）的比例高于EH组和对照组（43．4％vs27．5％vs15％．P〈0．01），三组间向心性肥厚（CCH）和向心性重构（CCR）的比例无显著性差异。结论糖尿病对老年高血压患者心脏结构有一定影响，高血糖可加重老年高血压患者心脏结构的异常。

Effect of type 2 diabetes mellitus on the cardiac structure in elderly hypertensive subjects

Objective To study the effect of type 2 diabetes mellitus on cardiac structure in elderly hypertensive subjects. Methods Three hundred and fifty-one elderly patients （ over 60 years） were categorized as ： essential hypertension （ EH ） group （ n = 149 ） , type 2 diabetes and hypertension （ T2DM ＋ EH ） group （n = 129） and control group（ n = 73 ）. To evaluate the cardiac structure according as the results of echocardiographic measurements. Results Left ventricular diameter（LVD） ,left ventricular mass（LVM） ,left ventricular mass index（LVMI） of T2DM ＋ EH group were higher than EH group（ P 〈 0.01 ）. There was significant difference in prevalence of left ventricular hypertrophy （LVH） between three groups （ EH ＋ T2DM ： 48.1 vs EH ： 34.9% vs Control： 17.8% , P 〈 0.05, 〈 0.01 ）. Prevalence of normal left ventricular geometry（NG） was lower in EH ＋ T2DM group than EH group and control group （EH ＋ T2DM ：44.2% vs EH： 56.4% vs Control ： 82.2%, P 〈 0.05 and 〈 0.01 ）. The incidence rate of ventricular eccentri hypertrophy （ECH） of EH ＋ T2DM gourp was significantly higher than the other groups （EH ＋ T2DM ：43.4% vs EH： 27.5% vs control： 15% , P 〈 0.01 ）. No significant difference was found in ventricular concentric remodeling（CCR） and ventricular eccentric hypertrophy （CCH） between three groups. Conclusions High level blood glucose can aggravation the cardiac structure of elderly hypertensive subjects.