CAJ | 학술논문

目的：探讨2型糖尿病患者心脏结构及功能的变化和引起心衰的相关危险因素，提高对糖尿病慢性心血管并发症的认识。方法随机选择170例2型糖尿病患者为研究对象，170例非糖尿病患者为对照组，并分别按是否合并心衰分为心衰患者和非心衰患者。比较2组患者左室后壁厚度（LVPWTH）、左室舒张末期内径（LVEDD）、左室收缩末期内径（ LVESD）、左室射血分数（ LVEF）和 E/A 的差异，采用 Logistic 回归分析引发心衰的相关危险因素。结果2型糖尿病组LVPWTH、LVEDD、LVESD增加，LVEF减少，E/A 降低，与对照组比较差异有统计学意义（ p＜0.05），其差异主要来自非心衰患者；回归分析显示，糖尿病病程、HbA1c达标情况及合并症高血压、冠心病、血脂异常等是2型糖尿病并发心衰的危险因素（均p＜0.05）。结论糖尿病导致心脏重构以及收缩和舒张功能障碍，即使无临床心衰症状的患者，心脏结构及功能可能已经出现异常。因此，应注意早期进行心脏检查及心功能评价，积极防治相关危险因素，避免心衰的发生。
목적：탐토2형당뇨병환자심장결구급공능적변화화인기심쇠적상관위험인소，제고대당뇨병만성심혈관병발증적인식。방법수궤선택170례2형당뇨병환자위연구대상，170례비당뇨병환자위대조조，병분별안시부합병심쇠분위심쇠환자화비심쇠환자。비교2조환자좌실후벽후도（LVPWTH）、좌실서장말기내경（LVEDD）、좌실수축말기내경（ LVESD）、좌실사혈분수（ LVEF）화 E/A 적차이，채용 Logistic 회귀분석인발심쇠적상관위험인소。결과2형당뇨병조LVPWTH、LVEDD、LVESD증가，LVEF감소，E/A 강저，여대조조비교차이유통계학의의（ p＜0.05），기차이주요래자비심쇠환자；회귀분석현시，당뇨병병정、HbA1c체표정황급합병증고혈압、관심병、혈지이상등시2형당뇨병병발심쇠적위험인소（균p＜0.05）。결론당뇨병도치심장중구이급수축화서장공능장애，즉사무림상심쇠증상적환자，심장결구급공능가능이경출현이상。인차，응주의조기진행심장검사급심공능평개，적겁방치상관위험인소，피면심쇠적발생。
Objective To investigate the changes of cardiac structure and function in type 2 diabetes mellitus (T2DM), analyze the related risk factors of heart failure, and improve the awareness of the effect of diabetes on the heart. Methods Randomly selected 170 cases of T2DM patients As the object of study, 170 cases of non diabetic patients as con-trol group, according to whether complicated with heart failure were divided into heart failure patients and non heart failure patients.Comparison of each group left ventricular posterior wall thickness, left ventricular end diastolic diameter, left ven-tricular end systolic diameter, left ventricular ejection fraction, E/A ratio Differences, analysis of the related risk factors of heart failure by logistic regressive.Results T2DM group left ventricular posterior wall thickness, left ventricular end diastolic diameter and left ventricular end systolic diameter increased , Left ventricular ejection fraction decreased, E/A ratio de-creased, were statistically significant difference compared with the control group (p <0.05).These differences are mainly come from non heart failure patients.Logistic regression showed that factors in patients with diabetes duration, HbA1c, com-pliance and complications of hypertension, coronary heart disease, is a risk factor for heart failure complicated with T2DM (all p<0.01).These may be the risk factor for diabetic patients with heart failure.Conclusion Diabetes can cause cardiac remodeling, systolic and diastolic dysfunction maybe some T2DM patients.They did not show symptoms of heart failure in the clinical, but their Cardiac structure and function are abnormal.We should pay attention to the cardiac function examination and early evaluation, prevention of risk factors, to avoid the occurrence of heart failure.