·糖尿病与心血管病·

　　作者单位：730000兰州，兰州大学第一医院老年病科(侯亚利、刘永铭、杨琳、王琳)，超声科(马苏美、薛丽丽)(第一作者现在河南省漯河中心医院内分泌科工作)

　　通讯作者：刘永铭，E-mail：cardtonm@263.net

　　侯亚利 刘永铭 马苏美 薛丽丽 杨琳 王琳

　　【摘要】 目的 探讨T2DM患者心脏功能的变化特点。 方法 T2DM患者90例，根据尿白蛋白排泄率(UAER)分为糖尿病1组(UAER<20μg/min)和糖尿病2组(UAER≥20μg/min)，选性别、年龄相当的正常人26名为对照组。 结果 与对照组比较，糖尿病1、2组二尖瓣A峰升高(P<0.01)，糖尿病1组E/E′S及E/E′L与E/E′S的均值(M-E/E′)有升高趋势，糖尿病2组E/E′S及M-E/E′进一步上升(P<0.01)。A峰与年龄、血压、HbA1c、糖尿病病程、UAER呈正相关;E/E′S、M-E/E′与年龄、NT-proBNP、左心房内径呈正相关。 结论 T2DM患者心功能变化主要表现为左室舒张功能减退，随着糖尿病肾病的出现，舒张功能减退更为显著;E/E′S、M-E/E′较之其他舒张功能指标敏感性更高。

　　【关键词】糖尿病，2型;心脏功能;超声心动图

　　doi:10.3969/j.issn.1006-6187.2011.11.011

　　Changes of heart function in patients with type 2 diabetes mellitus

　　HOU Ya-li, LIU Yong-ming, MA Su-mei, et al. Department of Geriatrics, the First Hospital of Lanzhou University, Lanzhou 730000, China

　　Corresponding Author: LIU Yong-ming, E-mail: cardtonm@263.net

　　【Abstract】 Objective To study the changes of heart function in patients with type 2 diabetes mellitus(T2DM). Methods Ninety consecutive patients with T2DM were divided into T2DM group 1(Urinary albumin excretion rate(UAER)<20μg/min, n=52) and T2DM group 2(UAER≥20μg/min, n=38). Twenty six age-and sex-matched healthy people were selected as controls. Results Compared with control group, the peak of A wave was increased in both T2DM group 1 and group 2 (P<0.01). The E/E′S ratio and M-E/E′ ratio(average of E/E′L ratio and E/E′S ratio) showed an increase in T2DM group 1 and a significant increase in group 2 (P<0.01). Peak A was positively correlated with age, blood pressure, HbA1c, duration of diabetes, and UAER, and E/E′S, M-E/E′ were positively correlated with age, NT-proBNP, and left atrial dimension(LAD). Conclusions The major cardiac functional changes of T2DM are left ventricular diastolic dysfunctions. With the emergence of diabetic nephropathy, the impairment of diastolic function is more prominent. E/E′s and M-E/E′ are more sensitive than the other parameters in evaluating cardiac dastolic fuction of T2DM.

　　【Key words】 Diabetes mellitus, type 2; Heart function; Echocardiography