CAJ | 학술논문

目的比较肥胖和非肥胖2型糖尿病患者的临床特点,探讨影响两组患者心功能的因素. 方法符合1999年糖尿病诊断标准的住院2型糖尿病患者238例.根据有无肥胖将所有患者分为肥胖组和非肥胖组.胰岛素敏感指数采用QUICKI公式.用二维指导下的M型超声心动图检测患者左心房大小、舒张末期左心室内径、左心室后壁厚度、室间隔厚度、射血分数.用超声多普勒检测E峰A峰比值.计算左心室质量指数. 结果 (1)肥胖组胰岛素敏感指数较非肥胖组高,高密度脂蛋白胆固醇水平较非肥胖组低;(2)肥胖组左心房内径、舒张末期左心室内径、左心室后壁厚度、室间隔厚度、左心室质量指数均大于非肥胖组;(3)多元逐步回归分析显示:肥胖组射血分数与左心室质量指数、空腹C肽呈负相关;非肥胖组射血分数与左心室质量指数、收缩压、尿酸呈负相关. 结论肥胖糖尿病患者存在明显的左心肥大,并与低胰岛素敏感性和低、高密度脂蛋白胆固醇并存;左心室肥大,无论在肥胖和非肥胖的糖尿病患者均影响左心室收缩功能;肥胖与非肥胖糖尿病患者还存在不同的与收缩功能有关的因素.
목적비교비반화비비반2형당뇨병환자적림상특점,탐토영향량조환자심공능적인소. 방법부합1999년당뇨병진단표준적주원2형당뇨병환자238례.근거유무비반장소유환자분위비반조화비비반조.이도소민감지수채용QUICKI공식.용이유지도하적M형초성심동도검측환자좌심방대소、서장말기좌심실내경、좌심실후벽후도、실간격후도、사혈분수.용초성다보륵검측E봉A봉비치.계산좌심실질량지수. 결과 (1)비반조이도소민감지수교비비반조고,고밀도지단백담고순수평교비비반조저;(2)비반조좌심방내경、서장말기좌심실내경、좌심실후벽후도、실간격후도、좌심실질량지수균대우비비반조;(3)다원축보회귀분석현시:비반조사혈분수여좌심실질량지수、공복C태정부상관;비비반조사혈분수여좌심실질량지수、수축압、뇨산정부상관. 결론비반당뇨병환자존재명현적좌심비대,병여저이도소민감성화저、고밀도지단백담고순병존;좌심실비대,무론재비반화비비반적당뇨병환자균영향좌심실수축공능;비반여비비반당뇨병환자환존재불동적여수축공능유관적인소.
Objectives To evaluate the factors that influence the cardiac function in obese and non obese type 2 diabetic patients and to survey the different clinic features between them. Methods 238 type 2 diabetic patients were divided into two groups. QUICKI formula was used for the calculation of insulin sensitivity. The LA (left atria), LVIDd (left ventricular internal diameter), post wall depth of left vetricular(LVPWd), intervetricular septum depth (IVSd), and ejection fraction (EF) were assaied by echocardiography. The ratio of transmitral early to atria peak ( E/A) flow velocity was used as an estimate of diastolic filling and function. Left ventricular mass index(LVMI) was caculated too. Results (1)Clinic features: insulin sensitivity index and high density lipoprotein cholesterol level was lower in obese group compared with non obese group; (2)Cardiac features: LA,LVIDd, LPWDd,LVSd, and LVMI were greater and diastolic filling was decreased in obese group; (3)Multiple liner regression showed that the EF was negatively correlated to LVMI and fasting C peptide(FCP) in obese group, and correlated negatively to LVMI, uric acid(UC), systolic blood pressure (SBP) in nonobese group. The equation was that EF1(obese group)=63.8 0.06 LVMI 0.322 FCP( P value was 0.000, 0.001, 0.046 respectively);EF2(non obese group)=59.3 0.127 LVMI 27.9 UC 0.003 SBP( P value was 0.042, 0.003, 0.021, 0.011, respectively). Conclusion The apparent left ventricular and atria hypertrophy exist in obese group and it coexists with low insulin sensitivity and low high density lipoprotein cholesterol level. The left ventricular hypertrophy (LVH) is the important factor that influences the systolic function of left ventricular in two groups. Besides, there are other factors that regulate the systolic function.