高血压和非高血压2型糖尿病人血清中Ⅲ型前胶原与透明质酸含量的观察

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目的 比较高血压和非高血压 2型糖尿病人与对照者血清中 型前胶原和透明质酸含量 ,以了解糖尿病人心肌纤维化的情况。方法 分别用放射免疫法测定、超声心功图检查比较了 4 0例糖尿病人 ,无糖尿病对照者 32名血清中人 型前胶原 (Procollagen ,PC )、透明质酸 (Hyaluronic,HA)含量和左心室质量指数 (left venticularmass index,L VMI)及左心室血流速度 E/ A比值。分组 :糖尿病无高血压组 DMl;糖尿病人有高血压组 DM2 ;对照无高血压组 CO1;对照有高血压组 CO2。并对 PC 的相关因素进行了多元逐步回归分析。结果  (1)糖尿病组和糖尿病有高血压组 PC 较高 ,与相应对照组、糖尿病无高血压组相比含量存在显著差异 (P<0 .0 5 ) ;糖尿病有高血压组与糖尿病无高血压组相比还存在 L VMI较高 ,射血分数 (ejection fraction,EF)较低的特点 (P<0 .0 5 ) ;(2 )糖尿病高 L VMI组比正常 L VMI组的 PC 含量高并有统计学意义 ;(3)多元逐步回归分析显示糖尿病组 (n=4 0 ) :PC 与年龄、病程正相关 ,与 Hb A1c、血管紧张素 (Ang )等无相关。结论  (1)糖尿病患者血清 PC 高提示心肌比非糖尿病人有更明显的纤维化的改变 ,高血压使之加重 ,左心室肥厚者具有较高的血清 PC 水平 ,心脏 PC 含量还随糖尿病病程的延长和增龄而 Objective To compare the serum levels of procollagen and hyaluronic acid in hypertensive and non-hypertensive patients with type 2 diabetes mellitus and controls to find out the myocardial fibrosis in diabetic patients. Methods The levels of Procollagen (PC), Hyaluronic (HA) in 32 serum samples of 40 diabetic and non-diabetic controls were compared by radioimmunoassay and echocardiography. Left ventricular mass index (LVVMI) and left ventricular blood flow velocity E / A ratio. Grouping: Diabetes mellitus without hypertension DMl; Diabetic patients with hypertension DM2; Control without hypertension CO1; Control with hypertension group CO2. The correlation factors of PC were analyzed by multiple stepwise regression. Results (1) PC in diabetic group and diabetes mellitus group were higher than those in control group and diabetes mellitus without hypertension group (P <0.05); there was no significant difference between diabetic hypertensive group and diabetic mellitus group Compared with the blood pressure group, the L VMI was higher and the ejection fraction (EF) was lower (P <0.05). (2) The PC content in high L VMI group was higher than that in normal L VMI group (3) Multiple stepwise regression analysis showed that diabetes group (n = 40): PC was positively correlated with age and course of disease, but not with Hb A1c and angiotensin (Ang). Conclusions (1) Serum PC in patients with diabetes mellitus suggests that myocardium has more obvious fibrosis changes than non-diabetic patients. Hypertension may aggravate them. Patients with left ventricular hypertrophy have higher serum PC levels. Cardiac PC content also varies with the duration of diabetes Extension and aging
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