2型糖尿病合并高血压患者心脏结构与功能变化特点

Structural and Functional Characteristics of Heart in Patients with Type 2 Diabetes and Hypertension

目的:探讨2型糖尿病(T2DM)合并高血压(EH)患者心脏结构和功能的变化特点,为心脏损害的防治提供理论依据。方法:364例患者分为T2DM组、EH组及T2DM合并EH组(DM+EH),对3组患者的相关临床资料及心脏多普勒等检查结果进行对比分析。结果:T2DM、EH及DM+EH3组患者左心室重量(LVM)差异有显著性意义(P<0.05),其中DM+EH组患者LVM高于其余2组;左室舒张末期内径(LV)、舒张末期室间隔厚度(IVS),EH、DM+EH组患者高于T2DM组(P<0.05);左心室后壁厚度(LVPW)、右室舒张末期内径(RV)、射血分数(EF)3组间差异均无显著性意义。但心脏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17.8%;舒张功能不全发生率为87.5%。结论:T2DM、EH及T2DM+EH三组患者心脏结构和功能变化明显不同,高血压能明显加重糖尿病患者心脏结构和功能的损害。

Objective：To investigate the structural and functional characteristics of heart in patients with type 2 diabetes and hypertension.Methods： A total of 364 subjects participated in the study.106 of them were patients with type 2 diabetes mellitus（T2DM）,136 were affected with essential hypertension（EH）,and 122 suffered from type 2 diabetes patients with hypertension（DM＋EH）.Color Doppler echocardiogram（CDE） examinations were carried out in all patients.The associated clinical data,including CDE,were analyzed.Results： ⑴There were significant differences in left ventricular mass（LVM） and the frequencies of systolic and diastolic cardiac dysfunction among EH,type 2 DM and DM＋EH patients.Compared with EH and T2DM patients,the subjects with DM＋EH had greater LVM,and also had higher rates of systolic and diastolic cardiac dysfunction,17.8% and 87.5% respectively.⑵The left ventricular and diastolic diameter（LVDd） in EH and EH＋DM was longer than that in T2DM,and so was the end diastolic inter ventricular septum（IVS） thickness.The left ventricular posterior wall（LVPW）,right ventricular（RVDd） and ejection fraction（EF） were not statistically different among them.Conclusions： The structural and functional characteristics are significantly different among EH,type 2 DM and DM＋EH patients.Hypertension may contribute to the damage of cardiac structure and function of diabetes patients with hypertension.