高血压合并糖尿病患者心脏结构与功能的变化特点

目的：探讨高血压（EH）合并2型糖尿病（T2DM）患者心脏结构和功能的变化特点，为心脏损害的防治提供依据。方法：281例患者，分为EH组合、T2DM及EH合并DM组（DM＋EH），以3组患者的相关临床资料及超声心动图检查结果进行对比分析。结果：DM、EH及DM＋EH3组患者左心室重量（LVM）、收缩期升主动脉内径（AO）差异有显著性意义（P＜0．05），其中DM＋EH组患者LVM、AO高于其余2组；舒张期左心内室内径（LV）、室间隔厚度（IVS）及收缩期左心房内径（LA），EH、DM＋EH组患者高于DM组（P＜0．05）；右心室内径（RV）、右心房内径（RA）、左心室后壁厚度（LVPW）、射血分数（EF）3组间差异均无显著性意义。但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16．5％，舒张功能不全发生率为91．5％，结论：T2DM、EH及T2DM＋EH3组左心室结构和功能变化明显不同，糖尿病合并高血压能明显加重患者左心室结构和功能损害。

Clinical characteristics of cardiac structure and function in patients with hypertensive diabetes mellitus

Objective To investigate the characteristics of cardiac structure and function in type 2 diabetes mellitus (DM) with or without hypertension and provide a clinical bases for prevention of cardiac dysfunction. Methods 281 patients were divided into essential hypertension (EH, n =108), type 2 DM ( n =84), and hypertensive DM ( n =89). Color Doppler echocardiogram were measured in all patients. Results Left ventricular mass (LVM) and aortic inner diameter (AO) in hypertensive DM were significantly increased compared with EH and type 2 DM. Left ventricle(LV), interventricular septum (IVS), left atrium(LA) were significantly increased in EH and hypertensive DM compared with type 2 DM. Right ventricular structure was not different among three groups ( P >0.05). The percentage of cardiac systolic and diastolic dysfunction increased significantly in hypertensive DM compared with EH and type 2 DM. Conclusion Changes in cardiac structure and function among type 2 DM, EH and hypertensive DM were markedly different. High blood pressure will promote the damage of cardiac structure and function in hypertensive DM.