2型糖尿病左心室舒张功能减退病人临床特点分析

The high prevalence of left ventricular dysfunction in type 2 diabetes

目的观察2型糖尿病左心室舒张功能减退的临床特征,探讨糖尿病心肌病变的病理过程。方法排除高血压,冠心病的2型糖尿病病人62例,进行心脏B超和组织多普勒检查,以左心室E/A假性正常化和E/A小于1作为左心室舒张功能减退标准,分析2型糖尿病病人左心室舒张功能减退的临床特征以及胰岛素抵抗指数等改变。结果2型糖尿病病人左心室舒张功能减退发生率60%(37/62),左心室舒张功能减退与病人年龄,糖尿病病程,尿白蛋白与肌酐比值和QTc延长相关。结论糖尿病病程和年龄因素可能参与糖尿病心肌病变的病理过程。

Objectives To observe the diabetes subjects with left ventricular diastolic dysfunction （LVDD） by tissue Doppler echocardiography. Methods We studied 62 diabetes patients with type 2 diabetes who were aged 37-56 years, and without evidence of diabetic complications, hypertension, coronary artery disease, congestive heart failure and with a maximal treadmill exercise test showing no ischemia. Pseudonormal pattern of ventricular filling and E/A〈1 which evaluated by Doppler echocardlography was regarded as left ventricular diastolic dysfunction （LVDD）. Results Systohc function was normal in all subjects, LVDD was found in 37 subjects （59.6%）. Despite there was no evidence of the metabolic abnormity, LVDD was correlation with age, course of diabetes,uALB/Cr and QTc prolonged. Conclusions There is a high prevalence of LVDD in diabetes patients without complication. The pathogenesis of diabetes cardiomyopathy may be associated with age and course of diabetes.