【摘要】 目的探讨原发性高血压(EH)、2型糖尿病(T2DM)、EH合并T2DM(EH+T2DM)患者心肌收缩力受损害的差别及部分影响因素。方法采用超声心动图(UCG)评价24例健康者、49例EH、20例T2DM和21例EH+T2DM患者的左心室壁内缩短分数(MFS)及应力相关MFS(S-cMFS),并同时检测糖化血红蛋白A1c(HbA1c)、血糖(GL)、24h尿总蛋白(TuA)、微量蛋白(MuA)、肾功能和血脂。结果与正常组比较,EH、T2DM和EH+T2DM组MFS和S-cMFS明显减少,T2DM和EH+T2DM组更为明显;单变量相关分析显示HbA1c、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)与MFS和S-cMFS呈显著相关,MuA与MFS呈显著负相关;多变量相关分析提示仅MuA和HbA1c与MFS显著相关,HbA1c与S-cMFS显著相关。结论EH、T2DM和EH+T2DM患者心肌收缩力明显损害,尤以EH+T2DM患者更显著,HbA1c和MuA是损害心肌收缩力的重要因素,TC、TG、LDL也可能具有不良影响。更多还原

【Abstract】 Objective To explore the different of myocardium contractility injury and affecting factors in patients with essential hypertension（EH）and type 2 diabetes mellius（T₂DM） or both type 2 diabetes and hypertension（T₂DM +EH）.Methods The left ventricular midwall fractional shortening（MFS）and stress-corrected MFS（S-cMFS）were assessed by Doppler echocardiography,at the same time,HbA1c,blood glucose（GL）,total urinary albuminuria（TuA）and urinary microalbumin of 24 hours（MuA）,renal function（blood urea,creatinine） and total cholesterol（TC）,triglyceride（TG）,low density lipoprotein-cholesterol（LDL） were measured in 24 cases of normal subjects,49cases of EH,20 cases of T₂DM and 21 cases of T₂DM +EH.Results MFS and S-cMFS in EH,T₂DM and T₂DM +EH patient groups,especially in T₂DM and T₂DM +EH patient groups were decreased significantly compared with normal group.Univariate correlation analyisis showed that HbA1c,TC,TG and LDLwere negatively correlated with MFS and S-cMFS.MuA was negatively correlated with MFS.Multivariate correlation analysis indicated that only MuA and HbA1c were positively related to MFS,HbA1c were related to S-cMFS.Conclusion the myocardium contractility in significantly damaged in EH,T₂DM,and T₂DM +EH patients groups,especially the T₂DM +EH patients group.HbA1c and MuA are the two of important factors for myocardium contractility injury.Maybe,TC,TG and LDL have the harm for affection.更多还原