论文部分内容阅读
目的探讨2型糖尿病患者早期肾功能损害与心室重构的关系。方法按照24 h尿微量白蛋白(UMA)水平将2015年2月-2016年8月四川省科学城医院收治的101例2型糖尿病患者分为两组,分别为糖尿病组(UMA定量<30mg/24 h)67例和微量白蛋白尿组(UMA定量为30~300 mg/24 h)34例,并于同一时期随机选取50例健康体检者为对照组。采用彩色多普勒超声诊断仪对左心室舒张期末内径(LVDD)、室间隔舒张期末厚度(IVS)、左心室后壁舒张期末厚度(LVPW)进行测量,并计算左心室重量(LVM)、左心室重量指数(LVMI)和相对室壁厚度(RWT),同时记录各组的血、尿等实验室检查指标,采用多重线性回归分析心室重构的影响因素。结果糖尿病组、微量白蛋白尿组LVPW、LVM、LVMI以及微量白蛋白尿组的RWT均高于对照组(P<0.05),且微量白蛋白尿组LVPW、LVM、LVMI、RWT均高于糖尿病组,差异均有统计学意义(P<0.05)。糖尿病组、微量白蛋白尿组TG、Fg、UA、FPG、2h PG以及微量白蛋白尿组的UMA均高于对照组(P<0.05),且微量白蛋白尿组TG、Fg、FPG、2h PG、UMA高于糖尿病组,差异有统计学意义(P<0.05)。多重线性回归分析显示:FPG、2h PG、UMA、年龄均为LVMI升高的显著影响因素(P<0.05)。结论 2型糖尿病早期肾功能损害患者易出现心室重构,且高龄、UMA升高是其独立危险因子,临床应重点关注这类高危人群,并采取针对性措施予以干预。
Objective To investigate the relationship between early renal dysfunction and ventricular remodeling in type 2 diabetic patients. Methods A total of 101 type 2 diabetic patients admitted to the Science City Hospital of Sichuan Province from February 2015 to August 2016 were divided into two groups according to the level of 24 h urinary albumin (UMA): diabetic group (UMA <30mg / 24 h) and microalbuminuria (UMA 30 ~ 300 mg / 24 h) in 34 patients. Fifty healthy subjects were randomly selected as the control group in the same period. Left ventricular end-diastolic diameter (LVDD), end-diastolic dimension (IVS) and left ventricular end-diastolic thickness (LVPW) were measured by color Doppler sonography and left ventricular mass Ventricular weight index (LVMI) and relative wall thickness (RWT) were recorded. Laboratory tests such as blood and urine were recorded. Multiple linear regression was used to analyze the influencing factors of ventricular remodeling. Results The RWT of LVPW, LVM, LVMI and microalbuminuria in diabetic group and microalbuminuria group were higher than those in control group (P <0.05), and the levels of LVPW, LVM, LVMI and RWT in microalbuminuria group were higher than those in diabetic group Group, the difference was statistically significant (P <0.05). The urinary levels of TG, Fg, UA, FPG, 2h PG and microalbuminuria in diabetic group and microalbuminuria group were higher than those in control group (P <0.05) PG, UMA higher than the diabetic group, the difference was statistically significant (P <0.05). Multiple linear regression analysis showed that FPG, 2h PG, UMA and age were the significant influencing factors of LVMI (P <0.05). CONCLUSION: Ventricular remodeling is prone to occur in patients with early renal impairment of type 2 diabetes mellitus. Elevated age and elevated UMA are independent risk factors for type 2 diabetes mellitus. Clinicians should pay special attention to these high risk groups and take appropriate measures to intervene.