老年糖尿病患者动脉硬化与左室收缩功能相关性研究

Associations between left-ventricular systolic function and arterial calcifications in elderly patients with type Ⅱ diabetes mellitus

目的通过回顾性分析糖尿病和非糖尿病人群中代表外周动脉硬化及僵硬度程度的肱踝脉搏波传导速度(ba PWV)、踝臂指数(ABI))与心脏收缩功能之间的相关性,探讨糖尿病对大血管及心脏收缩功能的影响。方法入组糖尿病患者48例,非糖尿病人群90例,均接受ba PWV、ABI及超声心动图检查,并留取血脂、糖化血红蛋白(Hb A1c)等相关临床资料。应用spearman相关分析各观察指标之间的相关性。结果基线资料比较显示,两组性别比例、血脂、尿酸水平差异均无统计学意义(P>0.05),Hb A1c、年龄差异有统计学意义(P<0.05);ABI、ba PWV差异有统计学意义(P<0.05)。心功能方面,左室射血分数(LVEF)、缩短分数(FS)差异无统计学意义(P>0.05)。组内分析显示,糖尿病组ABI与年龄、LVEF、Hb A1c之间存在相关性(相关系数r分别为0.67、0.42、0.47);ba PWV与年龄、BMI、Hb A1c及LVEF呈正相关(r分别为0.69、0.51、0.56、0.44)。非糖尿病组ABI同样与年龄、LVEF具有相关性(r分别为0.64、0.45);ba PWV与年龄、BMI、LVEF具有相关性(r分别为0.64、0.55、0.45)。结论无论在糖尿病还是非糖尿病人群中,ABI、ba PWV均与左室收缩功能的指标LVEF呈正相关性,即左室收缩功能受到外周动脉硬化及僵硬度的影响。

Objective To evaluate the associations between arterial calcifications and arterial stiffness,representing by brachial- ankle Pulse Wave- Velocity(ba PWV) and Ankle- Brachial Index(ABI), and cardiac systolic function among patients with or without Type 2 Diabetes Mellitus(T2DM); to explore the effects of T2 DM on great vessels and cardiac systolic function through retrospective analysis. Methods 48 patients diagnosed as T2 DM were enrolled in the case group and 90 patients without T2 DM were included in the control group. All patients received echocardiography, ba PWV and ABI test. Medical histories and laboratory examinations such as Hb A1 cwere collected too. Spearman's correlation was used to detect the associations between different variables within groups. Results According to the baseline data, there were no significant differences between two groups on gender, serum lipid levels and uric acid(P>0.05), and there were statistically significant differences on Hb A1 c, age, ABI, and ba PWV(P<0.05). For cardiac systolic function, there were no significant differences between different groups on left ventricular ejection fraction(LVEF) and fractional shortness(FS)(P>0.05). Within groups, the correlations of ABI with age, LVEF and Hb A1 cwere significant among patients with T2DM(r was 0.67, 0.42, 0.47 respectively)(P<0.05); the correlations of ba PWV with age, BMI,Hb A1 c, and LVEF were significant among T2 DM patients(r was 0.69, 0.51, 0.56, 0.44 respectively)(P<0.05). In the control group, the correlations of ABI with age and LVEF were significant(r was0.64, 0.45 respectively)(P<0.05); the correlations of ba PWV with age, BMI, and LVEF were significant(r was 0.64, 0.55, 0.45 respectively)(P<0.05). Conclusions ABI and ba PWV were associated with LVEF, which is an indicator of left- ventricular systolic function, among both patients with or without T2 DM. This means the situations of arterial calcifications and arterial stiffness could influence the left-ventricular systolic function.