糖尿病对射血分数保留心力衰竭患者血生化指标、心脏指标及生活质量的影响

Effects of Diabetes on Blood Biochemical Indexes,Cardiac Indexes and Quality of Life in Patients with Heart Failure with Ejection Fraction Retention

目的:探讨糖尿病(DM)对射血分数保留心力衰竭(HFpEF)患者血生化指标、心脏指标及生活质量的影响。方法:选取2017年1月-2019年5月我院收治的246例HFpEF患者作为研究对象,根据是否并发DM分为DM-HFpEF组(n=98)和NDM-HFpEF组(n=148),比较两组患者基线资料、血生化指标,采用超声心动图检测心功能参数,采用明尼苏达心力衰竭生活质量调查表(MLHFQ)评价患者的生活质量。结果:两组患者体重、收缩压、合并冠心病比例、合并高血压比例相比较,差异有统计学意义(P<0.05);与NDM-HFpEF组患者相比,DM-HFpEF组患者白细胞计数(WBC)、中性粒细胞计数(N)、血肌酐(Scr)、甘油三酯(TG)、空腹血糖(FBG)、餐后两小时血糖(2hPBG)、K+水平升高,血红蛋白(Hb)、高密度脂蛋白胆固醇(HDL-C)水平降低(P<0.05);DM-HFpEF组舒张末期左心室容积指数(LVEDVI)低于NDM-HFpEF组患者,室间隔厚度(IVS)、左心室后壁厚度(PWTD)、E峰、E/e'高于NDM-HFpEF组患者,差异有统计学意义(P<0.05);DM-HFpEF组患者MLHFQ中体力限制、社会限制、情绪、经济维度评分及总分高于NDM-HFpEF组患者,差异有统计学意义(P<0.05)。结论:DM促进了HFpEF患者IVS、PWTD的增厚,降低了心脏舒张功能和患者的生活质量,且明显加重了HFpEF患者血糖血脂的代谢紊乱。

Objective:To investigate the effects of diabetes(DM)on blood biochemical indexes,cardiac indexes and quality of life in patients with heart failure(HFpEF)with ejection fraction retention.Methods:The 246 patients with HFpEF from January 2017 to May 2019 were selected as the research objects.They were divided into DM-HFPEF group(n=98)and NDM-HFPEF group(n=148)according to whether DM was concurrent or not.The baseline data and blood biochemical indexes of the two groups were compared.The heart function parameters were detected by echocardiography.The quality of life of the patients was evaluated by Minnesota Heart Failure Quality of Life Questionnaire(MLHFQ).Results:There were statistically significant differences in body weight,systolic blood pressure,proportion of patients with coronary heart disease and proportion of patients with hypertension between the two groups(P<0.05).Compared with NDM-HFpEF group of patients,the white blood cell count(WBC),neutrophil counts(N),serum creatinine(Scr),triglyceride(TG),fasting blood glucose(FBG),postprandial 2 hours blood glucose(2 HPBG),K+levels of patients with DM-HFpEF group were increased.Hemoglobin(Hb),high-density lipoprotein cholesterol(HDL-C)level decreased(P<0.05).The end-diastolic left ventricular volume index(LVEDVI)of the DM-HFpEF group was lower than that of the NDM-HFpEF group,and the interventricular septal thickness(IVS),left ventricular posterior wall thickness(PWTD),E peak,E/e'were higher than those of the NDM-HFpEF group,the differences were statistically significant(P<0.05).The scores of physical limitation,social limitation,emotion,and economy and total scores in MLHFQ in patients with DM-HFpEF group were higher than those in patients with NDM-HFpEF group,the differences were statistically significant(P<0.05).Conclusions:DMpromotes the thickening of IVS and PWTD in patients with HFPEF,it can reduce diastolic function and quality of life.It also aggravates the metabolism disorder of blood glucose and blood lipid in patients with HFPEF.