【摘要】 目的   探讨T2DM合并心功能不全患者APN及抵抗素水平改变的临床意义。 方法  96例T2DM患者分为新诊断T2DM组33例，T2DM+心功能I～Ⅱ级组32例和T2DM+心功能Ⅲ～Ⅳ级组31例。另选健康体检者35名(NC组)。比较各组FPG、Fins、脑钠肽(BNP)、APN、抵抗素水平。心脏彩色多普勒测定左室射血分数(LVEF)、二尖瓣口舒张早期流速峰值E峰/舒张晚期流速峰值A峰(E/A)、舒张早期波e峰/舒张晚期波a峰(e/a)、峰值肺静脉血流收缩期S波/峰值肺静脉舒张早中期D波(S/D)。 结果    T2DM各组糖尿病病程、BMI、WC、HbA1c、抵抗素较NC组升高，APN较NC组降低。T2DM+心功能Ⅲ～Ⅳ级组E/A、LVEF、APN较其他组低(P<0.05)，抵抗素水平较其他组高(P<0.05)。T2DM+心功能I～Ⅱ级组和T2DM+心功能Ⅲ～Ⅳ级组e/a、S/D较其他组低(P<0.05)。心
脏彩色多普勒显示，T2DM各组E/A、e/a、S/D、LVEF较NC组下降(P<0.05).  结论    随着T2DM病程延长及心功能逐渐衰竭，APN、抵抗素水平及心肌舒张顺应性减低和收缩力下降。
   【关键词】 糖尿病，2型；心力衰竭；脂联素；抵抗素

   【Abstract】 Objective   To investigate the clinical value of APN and resistin levels in T2DM patientswith heart failure. Methods   A total of 96 T2DM patients and 35 healthy subjects were selected anddivided into four groups：newly-diagnosed T2DM group(T2DM group，n＝33)，T2DM with cardiac function I～II grade group (T2DM+cardiac function I～II grade group，n＝32)，T2DM with cardiac function Ⅲ～IV grade group(T2DM+cardiac function Ⅲ～IV grade group，n＝31) and normal controlgroup(NC group，n＝35)．Serum FPG，Fins，brain natriuretic peptide (BNP)，APN and resistin were measured and compared among four groups．The left ventricular ejection fraction (LVEF)，the ratios of mitrat early diastolic peak filling velocity toadvanced diastolic peak filling velocity (E/A)，early diastolic wave ereste tO advanced diastolic wave crest a (e/a )and pulmonary venous flow systolic S wave peak valueto earty-to-middiastolic D wave peak value (S/D )were catcuatedby color doppler echo cardiography inall subjects.   Results    Duration of DM，BMI，WC，HbA1C and resistin were higher but APN was 10wer in DM groups than in NC group．APN，E/A and LVEF were significantly lower but resistin level was significantly higher in T2DM+cardiac functionⅢ～Ⅳgrade group than in the other groups (P<0.05)．e/a and S/D were significantly lower in T2DM+cardiac function I～II grade group and T2DM+cardiac functionⅢ～lV grade group than in other groups (P<0.05)．Color doppler echocardiography resultsshowed that

E/A，e/a，S/D and LVEF were all significantly lower in T2DM groups than in NC group(P<0.05).    Conclusion    APN and resistin level decreased，and myocardial systolic and diastolic function declined with the progression of T2DM and aggravation of heart failure．
   【Key words】 iabetes mellitus，type 2；Heart failure；Adiponectin；Resistin