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目的分析不同分期糖尿病肾病患者舒张期心力衰竭的临床特点。方法将120例糖尿病肾病患者依据入院先后及病情程度分为糖尿病肾病Ⅲ期组(60例)和糖尿病肾病Ⅳ期组(60例),另取内分泌科单纯糖尿病患者60例作为对照组,分析3组患者超声心动图检查结果及血清钠尿肽(BNP)水平。结果糖尿病肾病Ⅳ组中LAD、LVEDd、二尖瓣E峰速度与二尖瓣环舒张早期峰值速度比值(E/Em)、血清BNP均显著高于对照组,E/A比值低于对照组,差异有统计学意义(P<0.05)。糖尿病肾病Ⅲ期患者E/A比值低于对照组,E/Em比值和BNP水平高于对照组,差异有统计学意义(P<0.05)。3组治疗前后EF水平差异无统计学意义(P>0.05)。结论糖尿病肾病Ⅲ期与Ⅳ期组患者中有较高的舒张期心力衰竭发病率。
Objective To analyze the clinical features of diastolic heart failure in patients with different stages of diabetic nephropathy. Methods 120 patients with diabetic nephropathy were divided into diabetic nephropathy stage Ⅲ group (60 cases) and diabetic nephropathy stage Ⅳ group (60 cases), and another 60 patients with endocrine department simple diabetes mellitus Group echocardiography test results and serum natriuretic peptide (BNP) levels. Results In the diabetic nephropathy group, the LAD, LVEDd, E peak velocity and early / early diastolic mitral annular velocity ratio (E / Em) and serum BNP were significantly higher in the diabetic nephropathy group than in the control group, and the E / A ratio was lower than that of the control group The difference was statistically significant (P <0.05). The E / A ratio of diabetic nephropathy stage Ⅲ patients was lower than that of control group, and the E / Em ratio and BNP level were higher than those of control group (P <0.05). There was no significant difference in EF level between the three groups before and after treatment (P> 0.05). Conclusion The incidence of diastolic heart failure is higher in stage Ⅲ and Ⅳ patients with diabetic nephropathy.