肥胖对非胰岛素依赖型糖尿病患者左心室功能的影响

Effect of Obesity on Left Ventricular Functions in Patients With Non insulin Dependent Diabetes Mellitus

目的：探讨肥胖对非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者左心室功能的影响。方法：采用超声心动图检测１８３例非胰岛素依赖型糖尿病患者左心室功能及结构参数。结果：不论血压正常或是合并高血压的非胰岛素依赖型糖尿病患者，随体重指数增大舒张期二尖瓣口血流频谱Ａ峰与Ｅ峰峰值流速比值（ＰＶＡ／ＰＶＥ）、每搏输出量、左心室重量指数均增加，二尖瓣前叶斜率、射血分数、短轴缩短率均降低，以血压正常者变化为著；舒张末期心室间隔厚度与左心室后壁厚度比值（ＩＶＳＴｄ／ＬＶＰＷＴｄ）则无变化。合并高血压的非胰岛素依赖型糖尿病患者较血压正常者有较高的ＰＶＡ／ＰＶＥ、ＩＶＳＴｄ／ＬＶＰＷＴｄ和左心室重量指数，而二尖瓣前叶斜率较低。结论：肥胖可诱发非胰岛素依赖型糖尿病患者左心室收缩功能异常并加重舒张功能损害。

Objective:To evaluate the effect of obesity on left ventricular (LV) functions in patients with non insulin dependent diabetes mellitus(NIDDM). Methods:The parameters of LV structure and function were measured by echocardiography and pulsed doppler in 183 NIDDM patients. Results:There were apparent increases of PVA/PVE,SV,LVMI(all p <0.05) and decreases of MEF,EF and FS (all p <0.05),but no significant change of IVSTd/LVPWTd with increase of body mass index (BMI) in either normotensive or hypertensive NIDDM patients.The changes were more obviously in normotensive NIDDM patients.Compared with normotensive NIDDM patients,hypertensive NIDDM patients had apparent increases of PVA/PVE,IVSTd/LVPWTd and LVMI,while decrease of MEF(all p <0.05). Conclusion:Obesity might cause LV systolic dysfunction and aggravate diastolic dysfunction in NIDDM patients.