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2型糖尿病合并高血压患者的心脏改变及其影响因素

雷永富1,李敏2   

  1. 1. 湖北江汉油田总医院（五七）
    2. 湖北省潜江市：江汉油田总医院（五七）
  • 收稿日期:2010-04-01 修回日期:2010-08-13 出版日期:2010-12-15 发布日期:2010-12-15
  • 通讯作者: 雷永富

Modification of Heart and Its Effect Factors in Patients with Type2 Diabetes Mellitus Accompanying Hypertension

  • Received:2010-04-01 Revised:2010-08-13 Published:2010-12-15 Online:2010-12-15

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摘要： 目的:探讨2型糖尿病伴高血压患者的心脏改变及其影响因素。方法:选择在本院住院的2型糖尿病伴高血压患者152例(A组)、单纯高血压病患者79例(B组)及38例健康体检者(C组)为研究对象,各组分别行动态血压监测(ABPM)、超声心动图(UCG)、糖化血红蛋白(HbA1c)及体质指数(BMI)等检查。比较各组间HbA1c、BMI、性别、年龄、昼间及夜间血压、左室质量指数(LVMI)、左室肥厚(LVH)、等容舒张期(IVRT)及E峰与A峰比(E/A)比值等指标的改变。结果:A组HbA1c高于另外2组,而3组间BMI、年龄及性别差异无统计学意义。A组及B组夜间的收缩压及舒张压均高于C组,A组的夜间收缩压高于B组。A组的LVMI、LVH的发生率高于B组、C组,A、B2组的IVRT均高于C组,A组的E/A比值低于B组及C组。结论:高血压患者LVMI增加,且LVH的发生率升高并伴有左室舒张功能障碍,而糖尿病加重这种改变,其原因可能与糖尿病的糖代谢异常及患者的夜间收缩压降低缺失有关。 

关键词: 糖尿病, 高血压, 左室肥厚, 左室舒张功能障碍

Abstract: Abstract： objective : To Explore the effect factors of left ventricular hypertrophy and left ventricular diastolic dysfunction in patients with type2 diabetes mellitus accompanying hypertension. Methods: one hundred and fifty-two patients with type2 diabetes mellitus accompanying hypertension (A group), seventy-nine essential hypertension patients ( B group) and thirty-eight healthy individual (C group) were submitted to 24-h Ambulatory Blood Pressure Monitoring (ABPM) and their echocardiography with Doppler、HbA1c and BMI were tested. some index changes were compared among groups including BMI 、HbA1c 、age 、sex 、 diurnal systolic blood pressure (DSBP)、 nocturnal systolic blood pressure(NSBP) 、LVMI 、LVH 、IVRT and E/A rate etc. Results: 1、HbA1c in A group is significantly higher than that in other two groups; BMI、sex and age did not differ among A. B. C groups. 2、Both NSBP and NDBP in A group and B group were higher than those in C group, NSBP in A group is higher than that in B group. 3、LVMI in A group exceed that in B group and C group ,the incidence of LVH in A group beyond that in B group and C group(20.4% vs 12.7% vs 2.6%, P<0.05,respectly),IVRT both A group and B group is higher than that in C group, E/A rate in A group is lower than that both B group and C group. Conclusion : LVMI increased and incidence of LVH risen in patients with hypertension and accompanying left ventricular diastolic dysfunction, moreover, those modification were worsen by diabetes mellitus, hyperglycemia and NSBP levels decrease deficiency should be responsible for them.

Key words: Key word diabetes mellitus, hypertension, LVH, left ventricular diastolic dysfunction