摘要
目的探究2型糖尿病(T2DM)病人脂代谢对病人心脏结构和功能的影响。方法测定2017年2月至2018年6月在亳州市人民医院确诊的84例T2DM和47例对照组的三酰甘油、总胆固醇、高密度胆固醇(HDL)、低密度胆固醇(LDL)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)及血糖水平,并通过超声心动图测定研究对象的左房前后径(LAD)、舒张末期室间隔厚度(IVSTd)、左室后壁厚度(LPWTd)、M型射血分数(EF)、右室前后径(RVIDd)、升主动脉内径(AO)、D期左室前后径(LVDd)、主肺动脉内径(PA)、左室舒张早期快速充盈峰(E峰)、左室舒张晚期充盈峰(A峰)、主动脉内流速(AV)、主动脉跨瓣压差(AVP)、肺动脉内流速(PV)和肺动脉跨瓣压差(PVP),且对两组间各指标进行比较,并对T2DM脂代谢指标和心脏结构及功能指标做相关性分析。结果T2DM与对照组相比,三酰甘油、总胆固醇、LDL、血糖、ApoB水平、LPWTd和PA值显著增加[1.74(1.36,2.77)mmol/L比1.23(0.96,1.53)mmol/L;(4.67±1.20)mmol/L比(4.18±0.52)mmol/L;(2.76±0.70)mmol/L比(2.48±0.44)mmol/L;8.92(7.49,12.11)mmol/L比5.10(4.83,5.35)mmol/L;(0.90±0.20)g/L比(0.78±0.14)g/L;9.00(8.00,10.00)mm比9.00(8.00,9.00)mm;20.00(20.00,21.00)mm比20.00(19.00,21.00)mm](P<0.05),而HDL显著降低[1.01(0.84,1.16)mmol/L比1.08(0.98,1.25)mmol/L](P<0.05);进一步做相关性分析,T2DM的LDL和IVSTd呈负相关(r=−0.21),血糖和LAD呈正相关(r=0.26),E峰和总胆固醇、HDL、LDL、ApoA、ApoB均呈负相关(r=−0.22;r=−0.26;r=−0.30;r=−0.23;r=−0.25)(P<0.05)。结论T2DM的血脂水平和心脏结构和功能呈负相关,血脂水平越高,心脏结构功能越差,了解血脂水平有利于评估病人的病情,加强早期干预有利于降低T2DM并发症。
Objective To explore the effect of lipid metabolism on cardiac structure and function in patients with type 2 diabetes mellitus(T2DM).Methods The levels of triacylglycerol(TG),total cholesterol(TC),high density lipoprotein(HDL),low density lipoprotein(LDL),apolipoprotein A(ApoA),apolipoprotein B(ApoB)and glucose(GLU)in 84 patients with T2DM and 47 patients in the control group in Bozhou People's Hospital from February 2017 to June 2018 were measured,and the left atrial dimension(LAD),interventricular septal thickness(IVSTd),left ventricular posterior wall thickness(LPWTd),M-type ejection fraction(m-EF),right ventricular diameter(RVIDd),diameter of ascending aorta(AO),left ventricular diameter in stage D(LVDd),pulmonary arterial diameter(PA),left ventricular early diastolic rapid filling peak(E peak),left ventricular late diastolic filling peak(A peak),intra-aortic velocity(AV),aortic transvalvular pressure difference(AVP),intrapulmonary velocity(PV)and transvalvular pressure difference of pulmonary artery(PVP)were determined by echocardiography.All of these indexes were compared between the two groups;The relationship between lipid metabolism and cardiac structure and function in T2DM was analyzed.Results Compared with those in the control group,the levels of TG,TC,LDL,Glu,ApoB,LPWTd and PA were significantly increased[1.74(1.36,2.77)mmol/L vs.1.23(0.96,1.53)mmol/L;(4.67±1.20)mmol/L vs.(4.18±0.52)mmol/L;(2.76±0.70)mmol/L vs.(2.48±0.44)mmol/L;8.92(7.49,12.11)mmol/L vs.5.10(4.83,5.35)mmol/L;(0.90±0.20)g/L vs.(0.78±0.14)g/L;9.00(8.00,10.00)mm vs.9.00(8.00,9.00)mm;20.00(20.00,21.00)mm vs.20.00(19.00,21.00)mm](P<0.05),while the level of HDL was significantly decreased[1.01(0.84,1.16)mmol/L vs.1.08(0.98,1.25)mmol/L](P<0.05).In addition,the GLU level positively correlated with LAD(r=0.26)while the E peak was negatively correlated with TC,HDL,LDL,ApoA and ApoB,respectively,in patients with T2DM(r=−0.22,r=−0.26,r=−0.30,r=−0.23,r=−0.25),also IVSTd negatively correlated with LDL(r=−0.21).Conclusions The level of blood lipid in T2DM is negatively correlated with cardiac structure and function.The higher the blood lipid level,the worse the cardiac function.Understanding the level of blood lipid is helpful to evaluate the condition of patients.
作者
付超
张静
董松武
FU Chao;ZHANG Jing;DONG Songwu(Department of Clinical Laboratory,Bozhou People's Hospital,Bozhou,Anhui 236800,China;Department of Cardiology,Bozhou People's Hospital,Bozhou,Anhui 236800,China)
出处
《安徽医药》
CAS
2021年第9期1735-1738,共4页
Anhui Medical and Pharmaceutical Journal
关键词
糖尿病
2型
脂代谢
心脏结构
Diabetes mellitus,type 2
Lipid metabolism
Cardiac structure
