摘要
目的研究2型糖尿病(T2DM)合并高血压患者心脏功能和胰岛素抵抗(IR)的关系,并分析影响其变化的危险因素,为临床治疗提供理论依据。方法选取2010年6月至2013年6月张家港市广和中西医结合医院300例T2DM患者作为研究对象,根据E/A比值进行分组。E/A比值小于或等于1为舒张功能降低,设为A组;>1为舒张功能正常,设为B组。A组160例患者,B组140例患者。检测并比较两组患者一般指标,胰岛素情况,心脏结构和功能指标。结果 A组患者血浆胰岛素、胰岛素抵抗指数(HOMA2-IR)分别为(28.68±7.61)IU/mL、(4.89±0.96),明显高于B组的(16.12±1.35)IU/mL、(2.80±0.29),差异有统计学意义(P<0.05)。Logistic回归分析显示,心脏舒张功能降低与年龄和HOMA2-IR有关,年龄越大、HOMA2-IR越高发生心脏舒张功能降低的风险越大;心脏舒张功能降低与病程、年龄、体质量指数、三酰甘油、高密度脂蛋白、低密度脂蛋白之间未见显著相关性(P>0.05)。结论 IR可导致心脏损害的发生,与左心室肥厚、心力衰竭之间存在着互相促进、恶性循环的关系。
Objective To investigate the relationship between cardiac function and insulin resistance （ IR） in patients with type 2 diabetes mellitus （T2DM ） and hypertension ,and to analyze the risk factors affected cardiac func-tion .Methods Three hundreds T2DM patients were selected as the research participants .According to the ratio of E/A ,all the participants were divided into two groups ,participants with E/A≤1 as diastolic function were in group A（160 cases） ,participants with E/A〉1 as normal diastolic function were group B （140 cases） .Detected and com-pared the general index ,fasting insulin（FINS） ,cardiac structure and function index in the two groups .Results The level of FINS ,HOMA-IR of patients in the group A were （28 .68 ＆#177; 7 .61）IU/mL and （4 .89 ＆#177; 0 .96） respectively were significant higher than （16 .12 ＆#177; 1 .35）IU/mL and （2 .80 ＆#177; 0 .29） in the group B ,the difference was significant （P〈0 .05） .Logistic regression analysis showed cardiac diastolic function decreased as age increased and as the risk of HOMA2-IR decreased .There were no significant correlation between the cardiac diastolic function decreasing and du-ration ,age ,body mass index ,triglyceride ,high density lipoprotein cholesterol ,low density lipoprotein cholesterol . Conclusion The occurrence and development of IR promotes heart damage ,and there was a vicious spiral between left ventricular hypertrophy ,heart failure and IR .
出处
《检验医学与临床》
CAS
2014年第19期2710-2711,共2页
Laboratory Medicine and Clinic
