血糖异常的冠心病患者左室舒张功能与动脉僵硬度的关系

The relationship between left ventricular diastolic function and arterial stiffness in diabetic coronary heart disease

目的 通过测定左室舒张功能、动脉僵硬度,探讨糖尿病对冠心病患者左室舒张功能和动脉僵硬度的影响,及左室舒张功能与动脉倡硬度之间的相关性.方法 将患者分为对照组、单纯冠心病绀、冠心病合并糖尿病组3组.测得左室舒张末压力（LVEDP）、左室压力衰退时间常数（tan）等左室舒张功能指标及脉搏波速度（c-f PWV）、校正心率后反射波增强指数（AIx@75）等反映患者动脉僵硬度指标.结果 冠心病合并糖尿病组c-fPWV[（8.79±1.59）cm/s]显著高于对照组[（6.83±1.14）cm/s]及单纯冠心病组[（7.43±1.42）cm/s].相关性分析显示AIx@75同tau指数之间存在正性相关性联系.结论 合并糖尿病的冠心病患者同对照组及单纯冠心病组相比动脉僵硬度更差,舒张功能差异未显示出统计学意义;动脉僵硬度同舒张功能不全间可能存在着一定的相关性.

Objectives By measuring left ventricular diastolic function and arterial stiffness,this study aims to probe into the effect of diabetes mellitus（DM） on left ventricular diastolic function and arterial stiffness,and evaluate the correlation between left ventricular diastolic funotion and arterial stiffness.Methods Seventy-six inpatients were enrolled.According to their coronary angiography,OGTF test results and past history of DM,patients were divided into controlled,CHD（coronary heart disease with no DM）,and CHD＋DM groups.Through invasive hemodynamic monitoring during left ventricular angiography,left ventricular end-diastolic pressure（LVEDP）and tan index were collected.Carotid-femoral pulse wave velocity（c-f PWV）,reflected wave augmentation index （AIx@75） and other data reflecting the degree of arterial stiffness were collected bedside with non-invasive means.SPSS 18.0 was used for statistical analysis.Results No significant difference was found between groups for LVEDP,tau index,and AIx@75.In terms of c-f PMV,The CHD＋DM group（8.79±1.59）cm/s differed significantly from the CHD group （7.43±1.42）cm/s and the controlled group（6.83±1.14）cm/s.No correlations were found between c-f PMV and LVEDP or tau index.A positive correlation was found between AIx@75 and tau index.Conclusions Compared with the controlled group and CHD patients with no DM,CHD＋DM patients show worse arterial stiffness with no difference in ventricular diastolic function.There is a positive correlation between arterial stiffness and diastolic dysfunction.