2型糖尿病患者心脏功能变化的研究

目的探讨T2DM患者心脏功能的变化特点。方法T2DM患者90例，根据尿白蛋白排泄率（UAER）分为糖尿病1组（UAER〈20μg／min）和糖尿病2组（UAER≥20μg／min），选性别、年龄相当的正常人26名为对照组。结果与对照组比较，糖尿病1、2组二尖瓣A峰升高（P〈0．01），糖尿病1组E／E′s及E／E′L与E／E′s的均值（M-E／E′）有升高趋势，糖尿病2组E／E′s及M-E／E′进一步上升（P〈0．01）。A峰与年龄、血压、HbA1c、糖尿病病程、UAER呈正相关；E／E′s、M-E／E′与年龄、NT-proBNP、左心房内径呈正相关。结论T2DM患者心功能变化主要表现为左室舒张功能减退，随着糖尿病肾病的出现，舒张功能减退更为显著；E／E′s、M-E／E′较之其他舒张功能指标敏感性更高。

Changes of heart function in patients with type 2 diabetes mellitus

Objective To study the changes of heart function in patients with type 2 diabetes mellitus（T2DM）. Methods Ninety consecutive patients with T2DM were divided into T2DM group 1 （Urinary albumin excretion rate（UAER）〈20μg/min, n=52） and T2DM group 2（UAER≥20μg/min, n =38）. Twenty six age-and sex-matched healthy people were selected as controls. Results Compared with control group, the peak of A wave was increased in both T2DM group 1 and group 2 （P〈0. 01）. The E/E′s ratio and M-E/E′ ratio（average of E/E′L ratio and E/E′s ratio） showed an increase in T2DM group 1 and a significant increase in group 2 （P〈0. 01）. Peak A was positively correlated with age, blood pressure, HbA1 c, duration of diabetes, and UAER, age, NT-proBNP, and left atrial dimension（LAD）. and E/E′s, M-E/E′were positively correlated with Conclusions The major cardiac functional changes of T2DM are left ventricular diastolic dysfunctions. With the emergence of diabetic nephropathy, the impairment of diastolic function is more prominent. E/E′s and M-E/E′ are more sensitive than the other parameters in evaluating cardiac dastolic ruction of T2DM.