老年糖尿病并高血压对心血管组织的影响

目的:探讨原发性糖尿病(DM)和高血压(EH)对老年人心血管病变的影响。方法:172名老年人按照血压、空腹血糖(FPG)、餐后2 h血糖(PG2 h)测定分为4组:健康对照组、DM组、EH组和EH伴DM组,每组43例。以超声波测量颈总动脉(CCA)、颈内动脉(ICA)内膜中层厚度(I MT),颈总动脉及颈内动脉最大血流速度(PSV)、颈总动脉及颈内动脉舒张末期血流速度(DV)、颈动脉阻力指数(RI)等指标;超声心动图测量左房内径(LAD)、左室舒张末期内径(LVDd)、左室收缩末期内径(LVDS)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室重量指数(LVMI)、相对室壁厚度(RWT)、peak E/A、左室短轴缩短率(FS)。结果:与健康对照组比较,DM组、EH组和EH+DM组的CCA-I MT和ICA-I MT显著增大,CCA-PV、ICA-PV显著降低(P0.05~0.01),EH组及EH+DM组的CCA-DV、ICA-DV显著减少(P0.05)。关于对心脏的影响,与健康对照组、DM组比较,EH组和EH+DM组的IVST、LVPWT、LVMI和RWT显著增大(P均0.05),E/A显著减小(P0.05)。EH组和EH+DM组的各项指标无显著差异(P0.05)。结论:高血压和糖尿病均能使颈动脉内膜中层厚度显著增厚,且高血压能引起心脏病变,为改善颈动脉病变应防治糖尿病和高血压。

Influence of diabetes and hypertension on cardiovascular tissue in aged patients with diabetes and hypertension

Objective： To investigate the influence of diabetes and hypertension on cardiovascular tissue in aged patients with diabetes mellitus （DM） and essential hypertension （EH）. Methods： According to the blood pressure, fasting plasma glucose and postprandial 2 h blood glucose levels, 172 aged peoples were average divided into 4 groups： normal control group, DM group, EH group and the EH group＋DM group. Ultrasound measurement of intima--media thickness （IMT）, maximum flow velocity （PSV）, resistance index （RI） in common carotid artery （CCA）, internal carotid artery （ICA） were measured. Eehocardiography measurements of left atrial diameter （LAD）, left ventricular end-diastolic diameter （LVEDd）, left ventricular end systolic diameter （LVESd）, interventricular septum thickness （IVST）, left ventricular posterior wall thickness （LVPWT）, left ventricular mass index （LVMI）, relative wall thickness （RWT）, peak E / A, left ventricular fractional shortening （FS） were performed. Results： （1） Compared with normal control group, the CCA- IMT and ICA- IMT significantly increased, CCA-PV and ICA- PV significantly decreased （P〈0. 05-〈0. 01） in DM group, EH group, and DM＋ EH group, also, the CC--DV, ICA-DV in EH group and EH＋DM group significantly decreased （P〈0.05） ; （2） Compared with normal control group and DM group, the IVST, LVPWT, LVMI and RWT significantly increased, E/A significantly decreased in EH group and DM＋ EH group （P〈0.05 all）; （3） Each index was no significant difference between EH group and DM＋ EH group. Conclusion： Diabetes and hypertension induced the carotid artery pathological change and hypertension induced the cardiac pathological change .