CAJ | 학술논문

目的：研究2型糖尿病（T2DM ）合并高血压患者心脏功能和胰岛素抵抗（IR）的关系，并分析影响其变化的危险因素，为临床治疗提供理论依据。方法选取2010年6月至2013年6月张家港市广和中西医结合医院300例T2DM 患者作为研究对象，根据 E/A比值进行分组。E/A比值小于或等于1为舒张功能降低，设为 A组；＞1为舒张功能正常，设为B组。A组160例患者，B组140例患者。检测并比较两组患者一般指标，胰岛素情况，心脏结构和功能指标。结果 A 组患者血浆胰岛素、胰岛素抵抗指数（HOMA2-IR）分别为（28．68±7．61） IU/mL、（4．89±0．96），明显高于B组的（16．12±1．35）IU/mL、（2．80±0．29），差异有统计学意义（P＜0．05）。Lo-gistic回归分析显示，心脏舒张功能降低与年龄和HOM A2-IR有关，年龄越大、HOM A2-IR越高发生心脏舒张功能降低的风险越大；心脏舒张功能降低与病程、年龄、体质量指数、三酰甘油、高密度脂蛋白、低密度脂蛋白之间未见显著相关性（ P＞0．05）。结论 IR可导致心脏损害的发生，与左心室肥厚、心力衰竭之间存在着互相促进、恶性循环的关系。
목적：연구2형당뇨병（T2DM ）합병고혈압환자심장공능화이도소저항（IR）적관계，병분석영향기변화적위험인소，위림상치료제공이론의거。방법선취2010년6월지2013년6월장가항시엄화중서의결합의원300례T2DM 환자작위연구대상，근거 E/A비치진행분조。E/A비치소우혹등우1위서장공능강저，설위 A조；＞1위서장공능정상，설위B조。A조160례환자，B조140례환자。검측병비교량조환자일반지표，이도소정황，심장결구화공능지표。결과 A 조환자혈장이도소、이도소저항지수（HOMA2-IR）분별위（28．68±7．61） IU/mL、（4．89±0．96），명현고우B조적（16．12±1．35）IU/mL、（2．80±0．29），차이유통계학의의（P＜0．05）。Lo-gistic회귀분석현시，심장서장공능강저여년령화HOM A2-IR유관，년령월대、HOM A2-IR월고발생심장서장공능강저적풍험월대；심장서장공능강저여병정、년령、체질량지수、삼선감유、고밀도지단백、저밀도지단백지간미견현저상관성（ P＞0．05）。결론 IR가도치심장손해적발생，여좌심실비후、심력쇠갈지간존재착호상촉진、악성순배적관계。
Objective To investigate the relationship between cardiac function and insulin resistance ( IR) in patients with type 2 diabetes mellitus (T2DM ) and hypertension ,and to analyze the risk factors affected cardiac func-tion .Methods Three hundreds T2DM patients were selected as the research participants .According to the ratio of E/A ,all the participants were divided into two groups ,participants with E/A≤1 as diastolic function were in group A(160 cases) ,participants with E/A>1 as normal diastolic function were group B (140 cases) .Detected and com-pared the general index ,fasting insulin(FINS) ,cardiac structure and function index in the two groups .Results The level of FINS ,HOMA-IR of patients in the group A were (28 .68 ± 7 .61)IU/mL and (4 .89 ± 0 .96) respectively were significant higher than (16 .12 ± 1 .35)IU/mL and (2 .80 ± 0 .29) in the group B ,the difference was significant (P<0 .05) .Logistic regression analysis showed cardiac diastolic function decreased as age increased and as the risk of HOMA2-IR decreased .There were no significant correlation between the cardiac diastolic function decreasing and du-ration ,age ,body mass index ,triglyceride ,high density lipoprotein cholesterol ,low density lipoprotein cholesterol . Conclusion The occurrence and development of IR promotes heart damage ,and there was a vicious spiral between left ventricular hypertrophy ,heart failure and IR .