CAJ | 학술논문

【目的】探讨超声心动图和 B 型脑钠肽(BNP)在2型糖尿病合并冠心病(T2DM+CHD)患者危险事件分层中的价值。【方法】选取2009年5月至2012年5月本院收治的92例 T2DM+CHD 的患者作为观察组，根据患者病情分为3个亚组；选取同一时期的 T2DM 的200例患者作为对照组；比较各组患者的性别、年龄、病程、血压、糖脂代谢和体质量指数(BMI)。使用 M 超声心动图、二维超声心动图(TED)和脉冲多普勒超声心动图测量并比较各组患者的心脏结构及功能，比较各组患者的 BNP 及心肌肌钙蛋白 I(cTnI)水平，并对 T2DM+CHD 的危险因素进行分析。【结果】各组患者的性别、年龄、舒张压(DBP)、BMI、舒张末期室间隔厚度(IVS)、左室舒张末期内径(LVIDd)和左室后壁厚度(LVPW)无统计学差异(P >0.05)；患者的病程、收缩压(SBP)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血脂、左室射血分数(LVEF)、左心室质量指数(LVMI)、左心房的灌注分数(LAFF)、左心房的射血分数(LAEF)、BNP 及 cTnI 具有统计学差异(P <0.05)。HbA1c、总胆固醇(TC)、低密度脂蛋白(LDL-C)、LVMI、LAEF、BNP 水平和 cTnI 水平是 T2DM+CHD 患者的危险事件发生的危险因素。【结论】超声心动图和血清 BNP 检测对T2DM+CHD 患者危险分层评价具有一定意义。
【목적】탐토초성심동도화 B 형뇌납태(BNP)재2형당뇨병합병관심병(T2DM+CHD)환자위험사건분층중적개치。【방법】선취2009년5월지2012년5월본원수치적92례 T2DM+CHD 적환자작위관찰조，근거환자병정분위3개아조；선취동일시기적 T2DM 적200례환자작위대조조；비교각조환자적성별、년령、병정、혈압、당지대사화체질량지수(BMI)。사용 M 초성심동도、이유초성심동도(TED)화맥충다보륵초성심동도측량병비교각조환자적심장결구급공능，비교각조환자적 BNP 급심기기개단백 I(cTnI)수평，병대 T2DM+CHD 적위험인소진행분석。【결과】각조환자적성별、년령、서장압(DBP)、BMI、서장말기실간격후도(IVS)、좌실서장말기내경(LVIDd)화좌실후벽후도(LVPW)무통계학차이(P >0.05)；환자적병정、수축압(SBP)、공복혈당(FPG)、당화혈홍단백(HbA1c)、혈지、좌실사혈분수(LVEF)、좌심실질량지수(LVMI)、좌심방적관주분수(LAFF)、좌심방적사혈분수(LAEF)、BNP 급 cTnI 구유통계학차이(P <0.05)。HbA1c、총담고순(TC)、저밀도지단백(LDL-C)、LVMI、LAEF、BNP 수평화 cTnI 수평시 T2DM+CHD 환자적위험사건발생적위험인소。【결론】초성심동도화혈청 BNP 검측대T2DM+CHD 환자위험분층평개구유일정의의。
[Objective]To explore the value of ultrasound cardiogram (UCG)and B-type natriuretic peptide (BNP)on the risk stratification of coronary heart disease events in patients with type 2 diabetes mellitus(T2DM) complicated CHD.[Methods]From May 2009 to May 2012,92 patients with T2DM and CHD (T2DM+ CHD) were chosen as study group and all patients were divided into 3 subgroups:stable angina pectoris(SAP,43 cases), unstable angina pectoris(UAP,32 cases)and acute myocardial infarction (AMI,1 7 cases).At the same time,200 patients with T2DM were chosen as control group.The gender,age,course of disease,blood pressure,glucose and lipid metabolism,as well as BMI were compared among different groups.The cardiac structure and function were measured by M-mode UCG,two dimensional echocardiogram(TED)and pulse Doppler echocardiography. The BNP and cTnI were compared among different groups and the risk factors were analyzed in patients with T2DM+CHD.[Results]The gender,age,DBP,BMI,IVS,LVIDd and LVPW had no statistical difference a-mong different groups (P > 0.05 ).The course of disease,SBP,FPG,HbA1c,blood lipid,LVEF,LVMI、LAFF,LAEF,BNP and cTnI had statistical difference among different groups(P <0.05).HbA1c,TC,LDL-C, LVMI,LAEF,BNP and cTnI were the risk factors for patients with T2DM+CHD.[Conclusion]UCG and BNP have very important significance in the the risk stratification of coronary heart disease events in patients with type 2 diabetes mellitus complicated coronary heart disease.