糖尿病对老年高血压患者心脏结构和功能的影响

Effect of type 2 diabetes mellitus on cardiac structure and function in elderly hypertensive subjects

目的探讨糖尿病对老年高血压患者心脏结构和功能的影响。方法将351例60岁以上的住院患者分为3组,即单纯高血压(EH)组149例,高血压合并2型糖尿病(T2DM)组129例和对照组73例,依据超声心动图结果评价心脏的结构和功能。结果与单纯EH组比较,EH+T2DM组的舒张末期左心室内径(LVD)、左室质量(LVM)、左室质量指数(LVWI)、收缩末期左心房内径(LA)、收缩末期升主动脉内径(AO)、射血分数(EF)、平均左室短轴缩短率(FS)、舒张晚期二尖瓣最大血流速度(A值)、左心室舒张早期二尖瓣最大血流速度(E值)/A值明显升高,EH+T2DM组E/A小于0.8或大于1.6的例数大于EH组和对照组(P=0.03);EH+T2DM组的房颤发生率大于对照组(P=0.012)。结论糖尿病对老年高血压患者心脏结构、收缩和舒张功能均有一定的影响,高血糖可加重老年高血压患者心脏结构和功能的异常。

Objective To study the effect of type 2 diabetes mellitus on cardiac structure and function in elderly hypertensive subjects. Methods Three hundred and fifty-one elderly patients（ over 60 years） were categorized as ： essential hypertension（ EH ） group（ n = 149 ）, type 2 diabetes and hypertension （ T2DM ＋ E H） group （n = 129 ） and control group（ n = 73 ）. To evaluate their cardiac structure and function according as the results of echocardiographic measurements. Results Left ventricular diameter（LVD） ,left ventricular mass（ LVM ） ,left ventricular mass index （LVWI） ,left atrial diameter（LAD） ,aoritic diameter（ AO）, ejection fraction（EF） ,average fractional shortening（FS） ,lately diastolic velocity （A value）and early diastolic velocity（ E value）/A of type 2 diabetes and hypertension group were higher than EH group（ P 〈 0. 05, P 〈0.01 ）. There were more patients whose E/A under O. 8 or over 1.6 in T2DM ＋ EH group than in EH group or the control group（P = 0.03 ）. The incidence of atrial fibrillation in EH ＋ T2DM group was higher than control group（P = 0. 012）. Conclusions Diabetes can effect the cardiac structure and function of elderly hypertensive subjects. High level blood glucose can aggravation the cardiac structure and function of elderly hypertensive subjects.