糖化血红蛋白对糖尿病患者血管内皮和左心结构与功能的影响
投稿时间:2014-12-10  修订日期:2014-12-29  点此下载全文
引用本文:段瑶,沈冲,吴永全,梁金锐.糖化血红蛋白对糖尿病患者血管内皮和左心结构与功能的影响[J].医学研究杂志,2015,44(7):91-95
DOI: 10.11969/j.issn.1673-548X.2015.07.026
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作者单位E-mail
段瑶 100050 首都医科大学附属北京友谊医院心血管中心  
沈冲 102400 北京市房山区良乡医院心内科  
吴永全 100050 首都医科大学附属北京友谊医院心血管中心 wuyongquan67@126.com 
梁金锐 100050 首都医科大学附属北京友谊医院心血管中心  
基金项目:首都市民健康基金资助项目(Z13110200400000)
中文摘要:目的 探讨不同水平的糖化血红蛋白(HbA1c)对2型糖尿病(T2DM)患者血管内皮和左心结构及功能的影响程度。方法 入选115例2型糖尿病患者,根据测得糖化血红蛋白水平分为HbA1c<7%组42例,HbA1c 7%~9%组42例,HbA1c>9% 组31例。同时入选82例健康志愿者作为正常对照组。应用外周动脉张力测定(PAT)技术检测所有入选者血管内皮细胞功能、计算反应性充血指数(RHI)。所有入选者均行超声心动图检查。结果 ①与正常对照组相比,HbA1c 7%~9%组和HbA1c>9%组患者的RHI值存在明显减低(P<0.05),且HbA1c>9%组患者RHI最低(P<0.05);②与HbA1c<7%组相比,HbA1c 7%~9%组和HbA1c>9%组患者舒张末期左心室后壁厚度(LVPW)、室间隔厚度(IVS)、左心室舒张晚期峰值速度(A)明显增加(P<0.05),左心室舒张早期峰值流速(E)、E/A值明显降低(P<0.05,P<0.01)。结论 糖化血红蛋白>7%时,2型糖尿病患者的内皮功能、左心结构及功能均会出现异常,其异常程度随着糖化血红蛋白的升高而加重。
中文关键词:2型糖尿病  糖化血红蛋白  内皮功能  左心结构与功能
 
Effect of HbA1c on Endothelial Function and Left Ventricular Structure and Function in Type 2 Diabetes Mellitus
Abstract:Objective To investigate the effects of the different glycated hemoglobin(HbA1c) on the endothelial function and the left ventricular structure and function in type 2 diabetes mellitus(T2DM). Methods A total of 115 cases patients with T2DM and 82 age and sex matched normal controls were enrolled in this study. They were divided into four groups: the control group of 82 cases, HbA1c<7% group of 42 cases, HbA1c 7%-9% group of 42 cases, 31 cases of HbA1c>9% group.The function of vascular endothelial cells was eraluated,and the reactive hyperemia index using PAT Technology (RHI). The left ventricular structure and function were evaluated according to the results of echocardiographic measurements. Results ①Compared with the control group,the RHI value of HbA1c 7%-9% group and HbA1c>9% group,reduced (P<0.05), and the patients in the HbA1c>9% group RHI was the lowest (P<0.05). ②Left ventricular posterior wall thickness(LVPW) and interventricular septal thickness(IVS) of HbA1c 7%-9% group and HbA1c>9% group were higher than HbA1c<7% group(P<0.05),meanwhile the ratio of E/A was much lower, especially in HbA1c>9% group(P<0.05 or P<0.01). Conclusion In T2DM patients with HbA1c>7%, the endothelial function and the left ventricular structure and function were involved. With the increase of HbA1c, the impairments were more prominent.
keywords:Type 2 diabetes mellitus  HbA1c  Endothelial function  Left ventricular structure and function
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