糖尿病患者动脉弹性与心血管耦联关系的初步研究

A preliminary study of the relationship between novel arterial stiffness and cardiovascular coupling in diabetes mellitus patients

目的探讨2型糖尿病(T2DM)患者动脉弹性与心血管耦联的关系。方法选取T2DM患者87例,依据是否合并高血压分为血压正常组(DM组)61例和合并高血压组(DM+HBP组)26例,另选无糖尿病及心脑血管病史的住院患者54例为对照组。分别获取各组血压[肱动脉收缩压、肱动脉舒张压、中心动脉收缩压、中心动脉脉压]和动脉弹性参数[动脉波速指数(AVI)、动脉压力容积指数(API)];应用超声心动图获取左室容积参数,计算心血管耦联参数[有效动脉弹性(Ea)、左室收缩末期弹性(Ees)及心血管耦联指数(VVI)],比较各组上述参数的差异。采用Spearman相关分析法分析动脉弹性参数与心血管耦联参数的关系。结果与DM组和对照组比较,DM+HBP组肱动脉收缩压、肱动脉舒张压、中心动脉收缩压和中心动脉脉压均升高,AVI、API和Ea均增大,差异均有统计学意义(均P<0.05);各组Ees和VVI两两比较,差异均无统计学意义。相关性分析显示,Ea与年龄、肱动脉收缩压、中心动脉收缩压、中心动脉脉压、AVI均呈正相关,与e/a呈负相关(均P<0.05);Ees与肱动脉收缩压、中心动脉收缩压、AVI均呈正相关(均P<0.05)。结论T2DM合并高血压患者动脉弹性和心室弹性同步增大,二者匹配耦联;增大的动脉弹性参数与心血管耦联参数呈正相关。

Objective To explore the relationship between novel arterial stiffness and cardiovascular coupling in patients with type 2 diabetes mellitus(T2DM).Methods A total of 87 patients with T2DM were selected and divided into a normal blood pressure group(DM group)of 61 cases and a hypertensive group(DM+HBP group)of 26 cases according to whether they were complicated with hypertension.Fifty-four subjects without the history of diabetes mellitus and cardiovascular disease were in the control group.Brachial artery systolic pressure,brachial artery diastolic pressure,central arterial systolic pressure,central arterial pulse pressure,and arterial elasticity parameters[arterial wave velocity index(AVI),arterial pressurevolume index(API)]were measured in each group.Left ventricular volume parameters were obtained by echocardiography,cardiovascular coupling parameters[effective arterial elasticity(Ea),left ventricular end-systolic elasticity(Ees)and cardiovascular coupling index(VVI)]were calculated,the differences of the above parameters in each group was compared.Spearman correlation analysis was used to analyze the relationship between arterial elasticity parameters and cardiovascular coupling parameters.Results Compared with DM group and the control group,the systolic blood pressure,diastolic blood pressure,central arterial systolic blood pressure and central arterial pulse pressure,AVI,API and Ea were increased in the DM+HBP group(all P<0.05),but Ees and VVI were not statistically significant difference among the three groups.Ea was positively correlated with age,systolic blood pressure,central arterial systolic blood pressure,central arterial pulse pressure and AVI,and negatively correlated with e/a(all P<0.05).Ees was positively correlated with systolic blood pressure,central arterial systolic blood pressure and AVI(all P<0.05).Conclusion Arterial stiffness and ventricular stiffness increase in parallel in diabetic patients,and the two are matched coupled,increased novel arterial stiffness indices positively correlates with the indices of ventricular-vascular coupling.