二甲双胍对原发性高血压合并糖尿病患者左心室肥厚的影响

Effect of metformin on left ventricular hypertrophy in patients with essential hypertension and diabetes mellitus

目的探讨二甲双胍对原发性高血压合并糖尿病患者左心室肥厚(LVH)的影响。方法选取2017年10月至2019年5月苏州市中医院收治的106例原发性高血压合并糖尿病患者为研究对象,对其进行2年的随访,根据随访期间是否服用二甲双胍分为二甲双胍组(n=54)和非二甲双胍组(n=52),然后根据服药时间对服用二甲双胍患者分为>1年(n=27)和≤1年(n=27)。比较组间一般资料和左室后壁厚度(LVPWD)、室间隔厚度(IVSD)、左室舒张末期内径(LVEDd)、左室质量指数(LVMI)等的基线值和随访值。采用Pearson相关分析和多重线性回归方法来探讨服用二甲双胍及其用药时间对LVH的影响。结果治疗后二甲双胍组LVPWD及LVMI均显著小于组内治疗前及非二甲双胍组(P<0.05)。治疗后二甲双胍组IVSD显著小于非二甲双胍组(P<0.05)。治疗后服药>1年患者LVMI显著小于组内治疗前及≤1年相应治疗后(P<0.05)。多重线性回归结果表明是否服用二甲双胍是LVPWD、LVMI的独立影响因素(P<0.05),二甲双胍服用时间是LVMI的独立影响因素(P<0.05)。结论二甲双胍能显著抑制原发性高血压合并糖尿病患者的LVH程度,改善心室重塑,且服药时间越长效果可能更佳。

Objective To investigate the effect of metformin on left ventricular hypertrophy(LVH) in patients with primary essential hypertension complicated with diabetes. Methods 106 patients with primary essential hypertension complicated with diabetes from October 2017 to May 2019 in Suzhou Traditional Chinese Medicine Hospital were enrolled the study and given 2 years of follow-up. According to whether taking metformin or not during the follow-up period, they were divided into metformin group(n = 54) and non-metformin group(n = 52). Then patients taking metformin were divided into >1 year group(n = 27) and ≤1 year group(n = 27). The baseline data, the baseline and follow-up values of Left ventricular posterior wall depth(LVPWD), interventricular septum depth(IVSD), left ventricular end-diastolic diameter(LVEDd), left ventricular mass index(LVMI) were compared among every groups. Pearson correlation analysis and multiple linear regression method were performed to investigate the effect of taking metformin and medication time on LVH. Results The follow-up values of LVPWD and LVMI in metformin group were significantly less than their baseline values in metformin group and corresponding follow-up values in non-metformin group(P<0.05). The follow-up value of IVSD in metformin group was significantly less than corresponding follow-up value in non-metformin group(P<0.05). The follow-up value of LVMI in >1 year group was significantly less than its baseline value in >1 year group and corresponding follow-up value in ≤1 year group(P<0.05). Results of multiple linear regression showed that whether taking metformin was the independent factors of LVPWD and LVMI(P<0.05), and the time of taking metformin was the independent factors of LVMI(P<0.05). Conclusions Metformin could inhibit the degree of LVH in patients with primary essential hypertension complicated with diabetes, improve ventricular remodeling. And the longer taking time, the better effect may be.