| 付超,张静,董松武.2型糖尿病病人脂代谢对心脏结构和功能的影响[J].安徽医药,2021,25(9):1735-1738. |
| 2型糖尿病病人脂代谢对心脏结构和功能的影响 |
| Effects of lipid metabolism on cardiac structure and function in patients with type 2 diabetes mellitus |
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| DOI：10.3969/j.issn.1009-6469.2021.09.009 |
| 中文关键词: 糖尿病， 2型 脂代谢 心脏结构 |
| 英文关键词: Diabetes mellitus, type 2 Lipid metabolism Cardiac structure |
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| 中文摘要: |
| 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)、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)主、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。 |
| 英文摘要: |
| 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 thecontrol group in Bozhou People's Hospital from February 2017 to June 2018 were measured, and the left atrial dimension (LAD), inter‐ventricular 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 levelsof 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 theblood lipid level, the worse the cardiac function. Understanding the level of blood lipid is helpful to evaluate the condition of patients. |
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