【摘要】 目的　比较肥胖和非肥胖 2型糖尿病患者的临床特点 ,探讨影响两组患者心功能的因素。　方法　符合 1999年糖尿病诊断标准的住院 2型糖尿病患者 2 38例。根据有无肥胖将所有患者分为肥胖组和非肥胖组。胰岛素敏感指数采用 QU ICKI公式。用二维指导下的 M型超声心动图检测患者左心房大小、舒张末期左心室内径、左心室后壁厚度、室间隔厚度、射血分数。用超声多普勒检测E峰 A峰比值。计算左心室质量指数。　结果　 (1)肥胖组胰岛素敏感指数较非肥胖组高 ,高密度脂蛋白胆固醇水平较非肥胖组低 ;(2 )肥胖组左心房内径、舒张末期左心室内径、左心室后壁厚度、室间隔厚度、左心室质量指数均大于非肥胖组 ;(3)多元逐步回归分析显示 :肥胖组射血分数与左心室质量指数、空腹 C肽呈负相关 ;非肥胖组射血分数与左心室质量指数、收缩压、尿酸呈负相关。　结论　肥胖糖尿病患者存在明显的左心肥大 ,并与低胰岛素敏感性和低、高密度脂蛋白胆固醇并存 ;左心室肥大 ,无论在肥胖和非肥胖的糖尿病患者均影响左心室收缩功能 ;肥胖与非肥胖糖尿病患者还存在不同的与收缩功能有关的因素。更多还原

【Abstract】 Objectives To evaluate the factors that influence the cardiac function in obese and non obese type 2 diabetic patients and to survey the different clinic features between them. Methods 238 type 2 diabetic patients were divided into two groups. QUICKI formula was used for the calculation of insulin sensitivity. The LA (left atria), LVIDd (left ventricular internal diameter), post wall depth of left vetricular(LVPWd), intervetricular septum depth (IVSd), and ejection fraction (EF) were assaied by echocardiography. The ratio of transmitral early to atria peak ( E/A) flow velocity was used as an estimate of diastolic filling and function. Left ventricular mass index(LVMI) was caculated too. Results (1)Clinic features: insulin sensitivity index and high density lipoprotein cholesterol level was lower in obese group compared with non obese group; (2)Cardiac features: LA,LVIDd, LPWDd,LVSd, and LVMI were greater and diastolic filling was decreased in obese group; (3)Multiple liner regression showed that the EF was negatively correlated to LVMI and fasting C peptide(FCP) in obese group, and correlated negatively to LVMI, uric acid(UC), systolic blood pressure (SBP) in nonobese group. The equation was that EF1(obese group)=63.8 0.06 LVMI 0.322 FCP( P value was 0.000, 0.001, 0.046 respectively);EF2(non obese group)=59.3 0.127 LVMI 27.9 UC 0.003 SBP( P value was 0.042, 0.003, 0.021, 0.011, respectively). Conclusion The apparent left ventricular and atria hypertrophy exist in obese group and it coexists with low insulin sensitivity and low high density lipoprotein cholesterol level. The left ventricular hypertrophy (LVH) is the important factor that influences the systolic function of left ventricular in two groups. Besides, there are other factors that regulate the systolic function.更多还原