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腹型肥胖对糖尿病合并高血压患者心脏结构和功能的影响

  • 吴妹珍,钟国强,蒋智渊

* 通信作者: 钟国强, 单位:广西医科大学第一附属医院

摘要


目的 探讨腹型肥胖对糖尿病合并高血压患者心脏结构和功能的影响。

方法 实验入组了2016年9月至2017年9月于香港大学深圳医院心内科住院的145例糖尿病合并高血压的病人,根据腰围(WC)将患者分为两组:正常腰围组(男性WC<90cm或女性WC<85cm),腹型肥胖组(男性WC≥90cm或女性WC≥85cm)。所有患者都行心脏彩超检查,心脏的结构、收缩功能、舒张功能参数及左室长轴整体应变(GLS)均予以测量。

结果 与正常腰围组相比,腹型肥胖组LVDd、LVPWd、LVMi、A和E/e mean较高 (分别P<0.05,P<0.05,P<0.05,P<0.05,P<0.05),E/A、e septal、e lateral、e mean、GLS低于正常腰围组 (分别P<0.05,P<0.01,P<0.01,P<0.01,P<0.05)。 LVDd (r = 0.29)、LVPWd (r = 0.35)、LVMi (r = 0.23)与腰围呈正相关,E/A (r =﹣0.24)、e septal (r =﹣0.21)、e lateral (r =﹣0.26)、e mean (r =﹣0.25)和GLS (r =﹣0.27)与腰围呈负相关。

结论 腹型肥胖有可能造成糖尿病合并高血压病患者心肌肥厚并导致心脏的收缩及舒张功能下降。

关键词:糖尿病合并高血压; 腹型肥胖; 心脏结构; 心脏功能

ABSTRACT


Objective To explore the impact of abdominal obesity on cardiac structure and function in hypertensive patients with type 2 diabetes mellitus.

Methods This study total enrolled 145 hypertensive patients with type 2 diabetes mellitus in the University of Hong Kong Shenzhen Hospital from September 2016 to September 2017. Patients were divided into two groups according to waist circumference (WC): normal waist circumference (WC<90cm for men or WC<85cm for women), abdominal obesity (WC≥90cm for men or WC≥85cm for women). All patients were performed echocardiographic examination, Echocardiographic parameters including LV geometry, systolic and diastolic function were measured and speckle tracking were used to measure global longitudinal strain (GLS).

Results Compared with normal waist circumference group, patients with abdomen obesity had larger LVDd (P< 0.05). LVPWd (P< 0.05), LVMi (P< 0.05), A-wave velocity (P< 0.05) and E/e mean (P< 0.05) were higher than normal waist circumference group. E/A ratio, e septal, e lateral, e mean and GLS were lower than normal waist circumference group (P< 0.05, P< 0.01, P< 0.01, P< 0.01, P< 0.05, respectively). Waist circumference was positively correlated with LVDd (r = 0.29), LVPWd (r = 0.35) and LVMi (r = 0.23), and negatively correlated with E/A (r =﹣0.24), e septal (r =﹣0.21), e lateral (r =﹣0.26), e mean (r =﹣0.25) and GLS (r =﹣0.27).

Conclusion   abdomen obesity may lead to left ventricular hypotrophy and left ventricular systolic and diastolic dysfunction.

Key words: Hypertensive patients with type 2 diabetes; Abdomen obesity; Cardiac structure; Cardiac function

引用本文 / How to Cite This Article

吴妹珍,钟国强,蒋智渊.腹型肥胖对糖尿病合并高血压患者心脏结构和功能的影响[J]. 国际精神病学杂志, 2018, 35(5): 690-693

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