高血压合并糖尿病对心脏形态及心功能的影响分析

Analysis of the influence of hypertension and diabetes on cardiac morphology and function

目的探究高血压合并糖尿病对心脏形态及心功能的影响情况。方法78例高血压患者,将其中39例合并糖尿病患者设为观察组,另39例单纯高血压患者设为对照组。两组患者均采用多层螺旋CT检测心脏形态指标,彩色超声仪检测心功能指标,动态血压监测仪进行24 h血压监测。比较两组动态血压监测情况、心脏形态指标及心功能指标。结果两组患者全天舒张压比较差异无统计学意义(P>0.05);观察组患者全天收缩压(142.76±18.87)mm Hg(1 mm Hg=0.133 kPa)、全天脉压(66.88±15.87)mm Hg、偶测脉压(71.88±17.74)mm Hg以及偶测收缩压(164.58±20.02)mm Hg均显著高于对照组的(131.66±18.00)、(54.46±15.54)、(61.87±15.46)、(157.65±19.88)mm Hg,偶测舒张压(90.88±15.55)mm Hg显著低于对照组的(97.76±13.76)mm Hg,差异具有统计学意义(P<0.05)。观察组患者的心冠状面面积、心横断面面积、心体积、左心室壁最小厚度、左心室壁最大厚度以及左心室腔面积均大于对照组,差异具有统计学意义(P<0.05)。两组患者二尖瓣口血流峰值速度A、左室舒张末期内径(LVEDD)以及左室收缩末期内径(LVESD)比较差异无统计学意义(P>0.05);观察组患者二尖瓣口血流峰值速度E及左室射血分数(LVEF)明显低于对照组,左室后壁舒张末期厚度(LVPWT)及室间隔舒张末期厚度(IVST)明显高于对照组,差异具有统计学意义(P<0.05)。结论高血压合并糖尿病患者心功能相较于单纯高血压患者更差,且多伴有左心房以及左心室增大情况。

Objective To investigate the influence of hypertension and diabetes on cardiac morphology and function.Methods Of the 78 patients with hypertension,39 patients complicated with diabetes were selected as the observation group,and 39 patients with simple hypertension were selected as the control group.The cardiac morphological indicators of the two groups was detected by multi-slice spiral CT,cardiac function indicators was detected by color ultrasound,and 24-h blood pressure was monitored by ambulatory blood pressure monitor.The monitoring of ambulatory blood pressure,cardiac morphology and cardiac function were compared between the two groups.Results There was no statistically significant difference in 24-h diastolic blood pressure between the two groups(P>0.05).The 24-h systolic blood pressure(142.76±18.87)mm Hg(1 mm Hg=0.133 kPa),24-h pulse pressure(66.88±15.87)mm Hg,occasional pulse pressure(71.88±17.74)mm Hg,and occasional systolic blood pressure(164.58±20.02)mm Hg of the observation group were significantly higher than those of the control group(131.66±18.00),(54.46±15.54),(61.87±15.46)and(157.65±19.88)mm Hg,and occasional diastolic blood pressure(90.88±15.55)mm Hg was significantly lower than that of the control group(97.76±13.76)mm Hg.The difference was statistically significant(P<0.05).The coronary surface area,cardiac cross-sectional area,cardiac volume,minimum left ventricular wall thickness,maximum left ventricular wall thickness,and left ventricular cavity area of the observation group were larger than those of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in peak mitral valve blood flow velocity A,left ventricular end-diastolic diameter(LVEDD),and left ventricular end-systolic diameter(LVESD)between the two groups(P>0.05).The peak mitral valve blood flow velocity E and left ventricular ejection fraction(LVEF)of the observation group were significantly lower than those of the control group,and left ventricular posterior wall enddiastolic thickness(LVPWT)and interventricular septal end-diastolic thickness(IVST)were significantly higher than those of the control group.The difference was statistically significant(P<0.05).Conclusion The cardiac function is worse in patients with hypertension and diabetes than in patients with simple hypertension,and it is often accompanied by enlargement of left atrium and left ventricle.