2型糖尿病患者血浆N-末端脑钠肽与左室功能的关系

目的探讨2型糖尿病(T2-DM)患者血浆N-末端脑钠肽(NT-proBNP)水平与左室功能关系。方法选取无心力衰竭症状的T2DM患者53例(DM组),正常对照组25例(N组)。所有患者测定血浆NT-proBNP,同时接受心脏超声检查。采用直线相关分析血浆NT-proBNP与心脏超声指标的关系。结果 DM组血浆NT-proBNP明显高于N组(P<0.01)。心脏超声检查显示,DM组患者的左心房内径(LAD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)和左室质量指数(LVMI)均较N组显著升高(P<0.05或P<0.01);而DM组的二尖瓣血流E峰速度与A峰速度的比值(E/A)则较N组显著降低(P<0.05)。直线相关分析显示,DM组的lg(NT-proBNP)与LAD、IVST、LVPWT、LVMI均呈正相关(r=0.43、0.28、0.31、0.55,P<0.05或P<0.01);lg(NT-proBNP)与E/A呈负相关(r=-0.34,P<0.05)。结论血浆NT-proBNP可作为T2DM患者左心功能的早期评估指标。

Relationship between N-terminal Pro-B-type Natriuretic Peptide and Left Heart Function in Patients with Type 2 Diabetes Mellitus

Objective To investigate the relationship between N-terminal pro-B-type natriuretic peptide(NT-proBNP) and left heart function in Patients with type 2 diabetes mellitus(T2-DM).Method Fifty three patients with T2DM and without clinical evidence of heart failure were divided into group DM,twenty five age and sex matched healthy people were selected as group N.Plasma NT-proBNP concentrations were measured,and echocardiography was performed in all patients.The correlation between plasma NT-proBNP concentration and parameters of echocardiography was explored by linear correlation analysis.Results The plasma NT-proBNP concentration in group DM was significantly higher than that in group N(P<0.01).Echocardiography revealed that the left atrial diameter(LAD),left ventricular posterior wall thickness(LVPWT),inter ventricular septal thickness(IVST) and left ventricular mass index(LVMI) significantly increased than those in group N(P<0.05 or P<0.01);but E/A ratio was significantly lower than that in group N(P<0.05).Linear correlation analysis indicated that lg(NT-proBNP)was positively related to LAD,IVST,LVPWT and LVMI in group DM(r=0.43,0.28,0.31,0.55,P<0.05 orP<0.01);but negatively related to E/A(r=-0.34,P<0.05).Conclusion Plasma NT-proBNP may serve as a parameter of early evaluation for left heart function in patients with T2-DM.