我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

急性冠脉综合征并发2型糖尿病的超声心动图特点及其相关因素

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2016年第1期
页码:
70-074
栏目:
临床研究
出版日期:
2015-09-15

文章信息/Info

Title:
Analysis of echocardiogram characteristics and associated factors in acute coronary syndrome patients with type 2 diabetes mellitus
作者:
李卫萍; 顾复生; 李虹伟
（首都医科大学附属北京友谊医院心血管中心，北京 100050）
Author(s):
LI Wei-ping;  GU Fu-sheng;  LI Hong-wei
(Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China)
关键词:
急性冠脉综合征; 2型糖尿病; 超声心动图
Keywords:
acute coronary syndromes;  type 2 diabetes mellitus;  echocardiogram
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 观察和分析急性冠脉综合征（ACS）并发2型糖尿病患者的超声心动图（UCG）特点及其相关因素。方法 纳入2012年6月~11月因ACS在我院住院的患者300例，其中糖尿病组126例，非糖尿病组174 例，比较两组的一般资料、临床检验指标、UCG各指标以及GRACE危险评分。 结果 糖尿病组中女性比例更高，入院即刻血糖、空腹血糖（FPG）、三酰甘油、GRACE评分更高（P<0.05或P<0.01）。UCG检查显示糖尿病组左室射血分数（LVEF）、每搏输出量和左室短轴缩短分数均显著降低，左室收缩末期内径和左室收缩末期容积显著增大（P<0.01），左室收缩功能轻度受损（LVEF 45%~54%）的比例显著升高（P<0.05）。相关分析提示糖尿病组LVEF与FPG、肌酐、GRACE评分显著负相关，而非糖尿病组LVEF与入院即刻血糖、肌酐、GRACE评分显著负相关（P<0.05或P<0.01）。多元线性回归分析结果表明FPG、体质量指数及性别是影响左室收缩功能的重要因素，其中FPG的标准回归系数最大（-0.312）。结论 ACS并发2型糖尿病患者，更早出现左室收缩功能障碍，与空腹血糖水平更高密切相关。
Abstract:
AIM To observe and analyze echocardiogram (ECG) characteristics and associated factors between acute coronary syndrome (ACS) patients with and without type 2 diabetes mellitus (T2DM). METHODSWe analyed 300 patients with ACS in our hospital from June to November 2012. Patients were divided into two groups: T2DM group and non-T2DM group. General data, blood test results, ECG parameters and GRACE risk scores were compared between groups. RESULTSThe rates of females, blood glucose at admission, fasting blood glucose (FBG), triglyceride and GRACE risk scores were higher in the T2DM group (P<0.05 or P<0.01). ECG results revealed that left ventricular ejection fraction (LVEF), stroke volume, and left ventricular fractional shortening were significantly lower, and left ventricular end systolic diameter and left ventricular end systolic volume were higher in the T2DM group group (P<0.01). Morever, more patients had mild damage of left ventricular systolic function (LVEF 45%-54%; P<0.05). LVEF in the T2DM group was negatively correlated with FBG, creatinine and GRACE risk scores, whereas it was negatively correlated with blood glucose at admission, and creatinine and GRACE risk scores in the non-T2DM group (P<0.05 or P<0.01). Multiple linear regression analysis showed that FBG, body mass index and sex independently predicted left ventricular systolic dysfunction and the standardized regression coefficient of FPG was greatest (-0.312). CONCLUSIONLeft ventricular systolic dysfunction occurs earlier in ACS patients with T2DM and is closely related to the higher level of FBG.

参考文献/References

[1]McGuire DK,Emanuelsson H,Granger CB,et al.Influence of diabetes mellitus on clinical outcomes across the spectrum of acute coronary syndromes. Findings from the GUSTO-IIb study. GUSTO IIb Investigators[J].Eur Heart J,2000,21(21):1750-1758.
[2]Granger CB,Goldberg RJ,Dabbous O,et al.Predictors of hospital mortality in the global registry of acute coronary events[J].Intern Med,2003,163(19):2345-2353.
[3]Yan AT,Yan RT,Tan M,et al.In-hospital revascularization and one-year outcome of acute coronary syndrome patients stratified by the GRACE risk score[J].Am J Cardiol,2005,96(7):913-916.
[4]Zhang X,Chen C.A new insight of mechanisms,diagnosis and treatment of diabetic cardiomyopathy[J].Endocrine,2012,41(3):398-409.
[5]Blomstrand P,Engvall M,Festin K,et al.Left ventricular diastolic function,assessed by echocardiography and tissue Doppler imaging, is a strong predictor of cardiovascular events,superior to global left ventricular longitudinal strain,in patients with type 2 diabetes[J].Eur Heart J Cardiovasc Imaging,2015,pii: ev027.[Epub ahead of print].
[6]Poulsen MK,Dahl JS,Henriksen JE,et al.Left atrial volume index relation to long-term clinical outcome in type 2 diabetes[J].J Am Coll Cardiol,2013,62(5):2416-2421.
[7]Dogdu O,Yarlioglues M,Kaya MG,et al.Relationship between psychosocial status,diabetes mellitus,and left ventricular systolic function in patients with stable multivessel coronary artery disease[J].Cardiol J,2012,19(3):249-255.
[8]Ehl NF,Kühne M,Brinkert M,et al.Diabetes reduces left ventricular ejection fraction-irrespective of presence and extent of coronary artery disease[J].Eur J Endocrinol,2011,165(6):945-951.
[9]Ferro A,Petretta M,Acampa W,et al.Post-stress left ventricular ejection fraction drop in patients with diabetes: a gated myocardial perfusion imaging study[J].BMC Cardiovasc Disord,2013,13:99.
[10]Andersson C,Solomon SD,Gislason GH,et al.Long-term prognostic importance of diabetes after a myocardial infarction depends on left ventricular systolic function[J].Diabetes Care,2011,34(8):1788-1790.
[11]Zhang Y,Tocchetti CG,Krieg T,et al.Oxidative and nitrosative stress in the maintenance of myocardial function[J].Free Radic Biol Med,2012,53(8):1531-1540.
[12]张海军，崔龙彪，岳 原，等.STZ 诱导的2 型糖尿病大鼠心肌组织TRPC7 的表达上调[J].心脏杂志,2014,26(4):403-407.
[13]Herchuelz A,Nguidjoe E,Jiang L,et al.Na(+)/Ca(2+) exchange and the plasma membrane Ca(2+)-ATPase in β-cell function and diabetes[J].Adv Exp Med Biol,2013,961:385-394.
[14]Sharma V,McNeill JH.Parallel effects of β-adrenoceptor blockade on cardiac function and fatty acid oxidation in the diabetic heart:Confronting the maze[J].World J Cardiol,2011,3(9):281-302.
[15]Sparks LM,Johannsen NM,Church TS,et al.Nine months of combined training improves ex vivo skeletal muscle metabolism in individuals with type 2 diabetes[J].J Elin Endocrinol Metab,2013,98(4):1694-1702.
[16]Takada S,Kinugawa S, Hirabayashi K, et al. Anglotensin II receptor blocker improves the lowered exercise capacity and impaired mitochondrialfunction of the skeletal muscle in type 2 diabetic mice[J].J Appl Physiol(1985),2013,114(7):844-857.
[17]Raza H,John A,Howarth FC.Alterations in glutathione redox metabolism,oxidative stress, and mitochondrial function in the left ventricle of elderly zucker diabetic Fatty rat heart[J].Int J Mol Sci,2012,13(12):16241-16254.
[18]Wu W,Sun Z,Li Q,et al.Influence of the glucose-lowering rate on left ventricular function in patients with type 2 diabetes and coronary heart disease[J].J Diabetes Complicat,2012,26(2):83-88.

备注/Memo

备注/Memo:
收稿日期：2015-03-26.
>基金项目：国家自然科学基金项目资助(81300161);北京市高层次卫生技术人才项目资助(2013-3-060)
通讯作者：李虹伟，教授，主要从事冠心病与糖代谢异常研究 Email：lhw19656@sina.com
作者简介：李卫萍，副教授，博士 Email:xueer09@163.com
更新日期/Last Update: 2015-09-16