2型糖尿病合并高血压患者心脏结构与功能变化特点

目的:探讨2型糖尿病(T2DM)合并高血压(EH)患者心脏结构和功能的变化特点,为心脏损害的防治提供理论依据。方法:364例患者分为T2DM组、EH组及T2DM合并EH组(DM+EH),对3组患者的相关临床资料及心脏多普勒等检查结果进行对比分析。结果:T2DM、EH及DM+EH3组患者左心室重量(LVM)差异有显著性意义(P<0.05),其中DM+EH组患者LVM高于其余2组;左室舒张末期内径(LV)、舒张末期室间隔厚度(IVS),EH、DM+EH组患者高于T2DM组(P<0.05);左心室后壁厚度(LVPW)、右室舒张末期内径(RV)、射血分数(EF)3组间差异均无显著性意义。但心脏收缩及舒张功能不全发生的百分率,3组间比较差异有显著性意义(P<0.05),其中DM+EH组发生率最高,收缩功能不全的发生率为17.8%;舒张功能不全发生率为87.5%。结论:T2DM、EH及T2DM+EH三组患者心脏结构和功能变化明显不同,高血压能明显加重糖尿病患者心脏结构和功能的损害。

Structural and Functional Characteristics of Heart in Patients with Type 2 Diabetes and Hypertension

Objective:To investigate the structural and functional characteristics of heart in patients with type 2 diabetes and hypertension.Methods: A total of 364 subjects participated in the study.106 of them were patients with type 2 diabetes mellitus(T2DM),136 were affected with essential hypertension(EH),and 122 suffered from type 2 diabetes patients with hypertension(DM+EH).Color Doppler echocardiogram(CDE) examinations were carried out in all patients.The associated clinical data,including CDE,were analyzed.Results: ⑴There were significant differences in left ventricular mass(LVM) and the frequencies of systolic and diastolic cardiac dysfunction among EH,type 2 DM and DM+EH patients.Compared with EH and T2DM patients,the subjects with DM+EH had greater LVM,and also had higher rates of systolic and diastolic cardiac dysfunction,17.8% and 87.5% respectively.⑵The left ventricular and diastolic diameter(LVDd) in EH and EH+DM was longer than that in T2DM,and so was the end diastolic inter ventricular septum(IVS) thickness.The left ventricular posterior wall(LVPW),right ventricular(RVDd) and ejection fraction(EF) were not statistically different among them.Conclusions: The structural and functional characteristics are significantly different among EH,type 2 DM and DM+EH patients.Hypertension may contribute to the damage of cardiac structure and function of diabetes patients with hypertension.