中国中西医结合急救杂志
中國中西醫結閤急救雜誌
중국중서의결합급구잡지
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2015年
5期
504-507
,共4页
中青年2型糖尿病%射血分数保留心力衰竭%糖化血红蛋白%心力衰竭中医证型
中青年2型糖尿病%射血分數保留心力衰竭%糖化血紅蛋白%心力衰竭中醫證型
중청년2형당뇨병%사혈분수보류심력쇠갈%당화혈홍단백%심력쇠갈중의증형
Young and middle-aged type 2 diabetes%Heart failure with preserved ejection fraction%Glycosylated hemoglobin%Traditional Chinese medicine syndrome types of heart failure
目的 观察中青年2型糖尿病合并射血分数保留心力衰竭(HF-PEF)患者的中医证型与糖化血红蛋白(HbA1c)水平,评价其相关性.方法 选取235例在厦门大学附属福州市第二医院心内科门诊及住院就诊的2型糖尿病患者,根据其舒张功能将其分为HF-PEF组120例和非HF-PEF(HF-NPEF)组115例.HF-PEF组按照中医辨证分型分为心气阴虚证、心肾阳虚证、气虚血瘀证、阳虚水泛证.采用高效液相层析法测定HF-PEF组和HF-NPEF组以及HF-PEF组不同中医证型患者的HbA1c水平;并根据血清HbA1c水平7.0%分组,比较不同血清HbA1c水平与HF-PEF患者中医证型严重程度的关系.结果 2型糖尿病合并 HF-PEF组患者血清HbA1c水平显著高于HF-NPEF组〔(7.02±0.74)%比(6.79±0.91)%,P<0.05〕;HF-PEF 组中心气阴虚证、心肾阳虚证患者的HbA1c水平比较差异无统计学意义〔(6.70±0.66)%比(6.70±0.68)%, P>0.05〕,而气虚血瘀证和阳虚水泛证患者HbA1c水平明显高于心气阴虚证和心肾阳虚证〔(7.15±0.70)%、(7.55±0.62)%比(6.70±0.66)%、(6.70±0.68)%〕,且阳虚水泛证患者HbA1c水平明显高于气虚血瘀证(P<0.01).HbA1c>7.0%组患者气虚血瘀证+阳虚水泛证发生率高于HbA1c≤7.0%组〔61.97%(44/71)比38.78%(19/49),P<0.05〕.Pearson相关性分析显示,HF-PEF组中,HF-PEF患者数与HbA1c呈正相关(r=0.610,P<0.05);HbA1c>7.0%组中,HbA1c与气虚血瘀证+阳虚水泛证的患者例数呈正相关(r=0.683,P<0.05).结论 血清HbA1c水平对中青年2型糖尿病合并HF-PEF患者的预后评估具有临床一致性,并与中医证型发展呈正相关.
目的 觀察中青年2型糖尿病閤併射血分數保留心力衰竭(HF-PEF)患者的中醫證型與糖化血紅蛋白(HbA1c)水平,評價其相關性.方法 選取235例在廈門大學附屬福州市第二醫院心內科門診及住院就診的2型糖尿病患者,根據其舒張功能將其分為HF-PEF組120例和非HF-PEF(HF-NPEF)組115例.HF-PEF組按照中醫辨證分型分為心氣陰虛證、心腎暘虛證、氣虛血瘀證、暘虛水汎證.採用高效液相層析法測定HF-PEF組和HF-NPEF組以及HF-PEF組不同中醫證型患者的HbA1c水平;併根據血清HbA1c水平7.0%分組,比較不同血清HbA1c水平與HF-PEF患者中醫證型嚴重程度的關繫.結果 2型糖尿病閤併 HF-PEF組患者血清HbA1c水平顯著高于HF-NPEF組〔(7.02±0.74)%比(6.79±0.91)%,P<0.05〕;HF-PEF 組中心氣陰虛證、心腎暘虛證患者的HbA1c水平比較差異無統計學意義〔(6.70±0.66)%比(6.70±0.68)%, P>0.05〕,而氣虛血瘀證和暘虛水汎證患者HbA1c水平明顯高于心氣陰虛證和心腎暘虛證〔(7.15±0.70)%、(7.55±0.62)%比(6.70±0.66)%、(6.70±0.68)%〕,且暘虛水汎證患者HbA1c水平明顯高于氣虛血瘀證(P<0.01).HbA1c>7.0%組患者氣虛血瘀證+暘虛水汎證髮生率高于HbA1c≤7.0%組〔61.97%(44/71)比38.78%(19/49),P<0.05〕.Pearson相關性分析顯示,HF-PEF組中,HF-PEF患者數與HbA1c呈正相關(r=0.610,P<0.05);HbA1c>7.0%組中,HbA1c與氣虛血瘀證+暘虛水汎證的患者例數呈正相關(r=0.683,P<0.05).結論 血清HbA1c水平對中青年2型糖尿病閤併HF-PEF患者的預後評估具有臨床一緻性,併與中醫證型髮展呈正相關.
목적 관찰중청년2형당뇨병합병사혈분수보류심력쇠갈(HF-PEF)환자적중의증형여당화혈홍단백(HbA1c)수평,평개기상관성.방법 선취235례재하문대학부속복주시제이의원심내과문진급주원취진적2형당뇨병환자,근거기서장공능장기분위HF-PEF조120례화비HF-PEF(HF-NPEF)조115례.HF-PEF조안조중의변증분형분위심기음허증、심신양허증、기허혈어증、양허수범증.채용고효액상층석법측정HF-PEF조화HF-NPEF조이급HF-PEF조불동중의증형환자적HbA1c수평;병근거혈청HbA1c수평7.0%분조,비교불동혈청HbA1c수평여HF-PEF환자중의증형엄중정도적관계.결과 2형당뇨병합병 HF-PEF조환자혈청HbA1c수평현저고우HF-NPEF조〔(7.02±0.74)%비(6.79±0.91)%,P<0.05〕;HF-PEF 조중심기음허증、심신양허증환자적HbA1c수평비교차이무통계학의의〔(6.70±0.66)%비(6.70±0.68)%, P>0.05〕,이기허혈어증화양허수범증환자HbA1c수평명현고우심기음허증화심신양허증〔(7.15±0.70)%、(7.55±0.62)%비(6.70±0.66)%、(6.70±0.68)%〕,차양허수범증환자HbA1c수평명현고우기허혈어증(P<0.01).HbA1c>7.0%조환자기허혈어증+양허수범증발생솔고우HbA1c≤7.0%조〔61.97%(44/71)비38.78%(19/49),P<0.05〕.Pearson상관성분석현시,HF-PEF조중,HF-PEF환자수여HbA1c정정상관(r=0.610,P<0.05);HbA1c>7.0%조중,HbA1c여기허혈어증+양허수범증적환자례수정정상관(r=0.683,P<0.05).결론 혈청HbA1c수평대중청년2형당뇨병합병HF-PEF환자적예후평고구유림상일치성,병여중의증형발전정정상관.
Objective To investigate traditional Chinese medicine (TCM) syndrome differentiations and glycosylated hemoglobin (HbA1c) levels in the young and middle-aged type 2 diabetic patients with heart failure and preserved ejection fraction (HF-PEF), and to evaluate the correlations between them.Methods 235 out- and hospitalized patients with type 2 diabetes from Department of Cardiology of Affiliated Fuzhou Second Hospital of Xiamen University were enrolled. They were divided into HF-PEF group (120 cases) and non-HF-PEF (HF-NPEF) group (115 cases) according to the diastolic function results of echocardiography. In the HF-PEF group, according to the TCM differentiation of syndromes, the patients were subdivided into four types: heart Qi and Yin deficiency, Yang deficiency of heart and kidney, Qi deficiency and blood stasis and edema syndrome due to Yang deficiency syndromes. The HbA1c levels of different TCM syndromes in HF-PEF and HF-NPEF groups were determined by high performance liquid chromatography. The patients of HF-PEF were further divided into two groups according to serum HbA1c levels > 7.0% or ≤ 7.0%, and the relationships between different serum HbA1c levels and different severity of TCM syndrome types of patients with HF-PEF were compared.Results The level of serum HbA1c in HF-PEF group was significantly higher than that in HF-NPEF group in patients with type 2 diabetes [(7.02±0.74)% vs. (6.79±0.91)%,P < 0.05]. There was no significant difference in HbA1c levels between heart Qi and Yin deficiency type and Yang deficiency of heart and kidney type in HF-PEF group [(6.70±0.66)% vs. (6.70±0.68)%,P > 0.05], while the HbA1c levels of Qi deficiency and blood stasis and edema syndrome due to Yang deficiency syndromes were significantly higher than those of heart Qi and Yin deficiency and Yang deficiency of heart and kidney types [(7.15±0.70)%, (7.55±0.62)% vs. (6.70±0.66)%, (6.70±0.68)%], and the HbA1c levels of edema syndrome due to Yang Deficiency was obviously higher than that of Qi deficiency and blood stasis (P < 0.01). In group of HbA1c > 7.0%, the incidence rate of Qi deficiency and blood stasis and edema syndrome due to Yang Deficiency types was higher than that of the group of HbA1c ≤ 7.0% [61.97% (44/71) vs. 38.78% (19/49),P < 0.05]. Pearson correlation analyses indicated that the number of patients with HF-PEF was positively correlated with HbA1c level in HF-PEF group (r = 0.610,P < 0.05); the HbA1c level was positively correlated with the number of patients with Qi deficiency and blood stasis and edema syndrome due to Yang Deficiency in HF-PEF group with HbA1c > 7.0% (r = 0.683,P < 0.05).Conclusion Clinically using serum HbA1c level to assess the prognosis of HF-PEF has obtained consistent results, and the level is positively correlated to the development of TCM syndrome types in young and middle-aged HF-PEF patients with type 2 diabetes.
