Ⅱ型糖尿病伴血压周期异常者左心室结构、功能的超声心动图改变

The echocardiographic changes of left ventricular structure and function in patients with type 2 diabetes and abnormal blood pressure period

目的 通过超声心动图检查 ,探讨Ⅱ型糖尿病患者伴血压周期异常患者的左心室结构及功能的异常 ,为这类型患者的早期发现和及时治疗提供依据。方法 采用 2 4小时动态血压监测仪和彩色多普勒诊断仪对 76例Ⅱ型糖尿病患者进行检查。根据动态血压结果把患者分为血压周期异常组 36例 (A组 )及血压周期正常组 4 0例 (B组 ) ,并同时配有正常健康人组作对照。再通过超声心动图检测左心室结构及功能各参数 :左心室重量 (LVM)、左心室重量指数(LVMI)、左室短轴缩短率 (ΔD % )、左室后壁增厚率 (ΔT % )、主动脉口最高血流速度 (AFVS)、主动脉口收缩期血流加速度(aAFV)、二尖瓣舒张早期流速 (VE)、二尖瓣舒张晚期流速(VA)、E/A比值等以评价血压周期异常对心脏的影响。结果 血压周期异常组 (A组 )的LVM、LVMI、VA、ΔD %、ΔT %、AFVS、aAFV明显较B组高 ,而E/A、VE 则明显较B组低。结论 Ⅱ型糖尿病近半数存在昼夜血压比值紊乱 ,他们的左心室结构、功能的异常可能与昼夜血压比值紊乱有关 ,因此在治疗Ⅱ型糖尿病时 ,对存在有血压周期异常者 ,即使没有高血压都应重视夜间血压的控制 ,以减少心血管的并发症。

Objective To evaluate the influence of abnormal blood pressure on left ventricular structure and function of type 2 diabetic patients by echocardiography examination, and to achieve better treatment for type 2 diabetic patients and reduce their cardiovascular complication. Methods Used 24 hour blood pressure monitor and doppler echocardiography to analyze a group of 76 type 2 diabetic patients. According to blood pressure monitor results, these patients were divided into a group of 36 patients (group A) with abnormal blood pressure period (the ratio of mean blood pressure of night/day time≥0.9) and a group of 40 patients (group B) with normal blood pressure period (the ratio of mean blood pressure of night/day time<0.9). The results were compared with normal subjects. Echocardiograph was used to evaluate the left ventricular structure and the functional parameters including: LVM, LVMI,ΔD%,ΔT%,AFVS,aAFV,V E,V A and E/A.Results The LVM, LVMI,V A,ΔD%,ΔT%,AFVS,aAFV in group A were higher than those in group B, while E/A and V E in group A were lower than those in group B. Conclusion The changes of left ventricular structure and function in type 2 diabetic patients is related to the abnormal change of blood pressure period. For reducing the cardiovascular complications the controlling of night blood pressure for treatment of type 2 diabetic patients is very important, either they have hypertension or not.