糖尿病合并冠状动脉狭窄患者左室造影前后左室舒张末压差值比较研究

Impact of Diabetes Mellitus on the Change of Left Ventricular End-diastolic Pressure After Left Ventricular Angiography of the Patients with Coronary Artery Disease

目的探讨糖尿病对合并冠状动脉狭窄患者左室造影前后舒张末压差值和左室功能的影响。方法选择行冠状动脉造影及左室造影的患者834例,其中无冠脉病变的患者172例,冠状动脉狭窄的患者662例。根据其有无糖尿病,将之分为糖尿病合并冠状动脉狭窄组(DM组)110人,及单纯冠状动脉狭窄组(非DM组)552人,所有病人都进行左室造影,测定左室射血分数(EF),造影前后左室舒张末压(D1、D2)。结果DM组患者造影前后左室舒张末压的差值(D3)明显高于非DM组的患者,两组间的射血分数无明显差异,年龄增加、糖尿病、EF的降低,与造影前后左室舒张末压的差值呈负相关。结论糖尿病合并冠状动脉狭窄患者可以在心脏的收缩功能发生异常之前,表现出对心脏舒张功能的损害,而造影前后,左室舒张末压的差值可以更为敏感地反映左室舒张功能的改变。

Objective To study the impact of diabetes mellitus on the change of left ventricular end-diastolic pressure after left ventricular angiography and the function of left ventricular of the patients with coronary artery disease. Methods Data were retrospectively collected on 834 patients undergoing coronary and left ventricular angiography. 172 patients had no significant coronary artery disease(CHD). Among 662 CHD patients, coronary heart disease complicated with diabetes mellitus(110 patients) was indicated as DM group and the coronary artery disease without diabetes (552 patients) was indicated as non-DM group. All patients were examined by left ventricular angiograph by which ejection fraction and left ventricular end-diastolic pressure were measured . Results The change of left ventricular end-diastolic pressure after angiography of the patients in DM group was significiantly higher than that in non-DM group. But there was no significant diference of ejection fraction between two groups. Conclusions Diabetes mellitus can impair heart's diastolic function before the systolic function on the coronary heart disease patients.