2型糖尿病合并高血压患者左心室结构和功能变化

目的 探讨2型糖尿病患者在并发或不并发高血压时的心脏结构和功能的变化。方法 2型糖尿病98例，依血压水平分为单纯2型糖尿病组50例，2型糖尿病合并高血压组48例，对照组30例为体检健康者。观察血糖、血脂、体重指数，应用超声心动图仪检测左心室结构和功能。结果 与对照组相比，2型糖尿病患者有糖、脂代谢异常（P〈0.05），3组之间左心室舒张末内径（left ventricular end diastolic dimension，LVEDd）、室间隔厚度（interventricular septum thickness，LVST）、左心室后壁厚度（left ventricular posterior wall thickness，LVPWT）及左心室质量指数（left ventricular mass index，LVMI）差异有统计学意义（P〈0.05），2型糖尿病合并高血压组明显高于其他两组（P〈0.05），3组间舒张早期血流充盈峰值流速E值及E/A比值差异无统计学意义（P〈0.05），2型糖尿病合并高血压组下降更明显;与对照组相比，2型糖尿病合并高血压组的左心室射血分数（left ventricular ejection fraction，LVEF）、左心室短轴缩短率（fractional shortening，FS）下降（P〈0.05）。结论 2型糖尿病患者存在左心室结构及功能受损，随血压升高，这些改变更为明显。

Left ventricular structure and function in patients with type 2 diabetes mellitus complicated or not complicated with hypertension

Abstract : Objective To study the change of left ventricular structure and function in patients with type 2 diabetes mellitus. Methods 98 cases of type 2 diabetes mellitus were divided into two group: the group of normotensive diabetes mellitus (group T2DM, n=50) and the group of hypertensive diabetes mellitus (group T2DM+EH, n=48), according to their complication of essential hypertension. 30 normal persons were enrolled for control. Fasting plasma glucose, fasting plasma lipid and body mass index were determined, left ventricular configuration and function by means of echocardiography were assessed. Results Compared with normal subjects , group T2DM and group T2DM+EH had greater left ventricular of end diastolic internal dimension, left ventricular of end diastolic interventricular septal thickness, left ventricular end of diastolic posterior wall thickness , left ventricular mass index (P<0.05). While E wave velocity , E/A, left ventricular ejection fraction, left ventricular fractional shortening were decreased in both group T2DM and group T2DM+EH, especially in group T2DM+EH(P<0.05). Conclusion The left ventricular structure and function were significantly be impaired in patients with type 2 Diabetes mellitus, high blood pressure aggravate the remodeling of left ventricular in type 2 Diabetes mellitus.