【摘要】 目的 了解反复低血糖T2DM患者的临床特点及其对心功能的影响。 方法 收集反复低血糖T2DM患者(反复低血糖组)44例和同期无低血糖T2DM患者(无低血糖组)68例，调查两组临床资料、生化指标、糖尿病并发症及合并症、治疗方案、心肌酶谱和左室射血分数(EF)等，并进行统计分析。 结果 (1)与无低血糖组相比，反复低血糖组病程、Cr、UA、2 hIns更高，GT、FPG、2 hPG、HbA1c、CCr降低(P均<0.05);(2)两组脑血管疾病发生率比较，差异有统计学意义[17(38.6) vs 12(17.6)，P<0.05];(3)反复低血糖组二甲双胍使用率低，预混胰岛素使用率高(P均<0.05);(4)与非低血糖组比较，反复低血糖组患者EF降低[(0.63±0.06)% vs (0.66±0.05)%，t=-3.051，P<0.05]，而α羟丁酸脱氢酶(α-HBDH)升高[138(120，150) vs 110(96，125) U/L，z=-4.284，P<0.05];(5)对EF行多元线性回归分析显示，EF与反复低血糖呈负相关(β=0.037，t=3.217，P<0.05)。 结论 反复低血糖可能对心功能产生不利影响，导致EF减低。糖尿病病程长、肾功能降低、FPG较低和使用预混胰岛素治疗的患者是反复低血糖发生的危险人群，应尽量避免或减少应用预混胰岛素治疗。

　　【关键词】 糖尿病，2型;反复低血糖;心功能影响

　　【Abstract】 Objective To explore the influences of repeated hypoglycemia on the cardiac function in patients with type 2 diabetes mellitus. Methods 44 diabetic patients with repeated hypoglycemia (repeated hypoglycemia group) and 68 without hypoglycemia(without hypoglycemia group) were selected in this study, The clinical data, biochemical parameters, the incidences of complications and co-morbidities, therapeutic schedule, myocardial enzymes and left ventricular ejection fraction were researched and analyzed between the two groups. Results (1)The course, Cr, UA, 2 hIns was higher in repeated hypoglycemia group than in without hypoglycemia group, but the GT, FPG, 2 hPG, HbA1c, CCr was lower (all P<0.05). (2)The difference in the incidence of cerebrovascular disease between two groups [17(38.6) vs 12(17.6)，P<0.05]. (3)The rate of usage metformin was lower and using the premixed insulin was higher in repeated hypoglycemia group than in without hypoglycemia group. (4)The ejection fraction (EF) was reduced [(0.63±0.06) vs (0.66±0.05)，t=-3.051, P<0.05]， and the α-hydroxybutyric dehydrogenase was increased [138(120，150) vs 110(96，125) U/L， z=-4.284， P<0.05] in repeated hypoglycemia group significantly. (5) Multiple linear regression analysis showed that repeated hypoglycemia was negatively related with EF(β=0.037，t=3.217，P<0.05). Conclusions Repeated hypoglycemia may produce side effects on heart function and reduce ejection fraction. The diabetic patients with long course, impaire renal function and low FPG are high-risk population for hypoglycemia and should be paid great attention to the application of premixed insulin.

　　【Key words】 Diabetes mellitus, type 2; Repeated hypoglycemia; Cardiac function