论文部分内容阅读
目的研究中老年糖尿病患者心脏血流动力学的特点,探讨利用无创血流动力学监护系统早期发现糖尿病心脏病变的敏感指标。方法将218例研究对象分为正常对照组(n=130)、糖尿病前期组(n=23)和糖尿病组(n=65),测定体质量指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、收缩压(SBP)、舒张压(DBP)、脉压(PP)、平均动脉压(MAP)等指标。应用LIFEGARDII型无创血流动力学监护系统测定心输出量(CO)、心脏指数(CI)、体循环血管阻力(SVR)、体循环血管阻力指数(SVRI)、每搏输出量(SV)、每搏指数(SI)、胸腔液体量(TFC)、加速度指数(ACI)、左心做功指数(LCWI)、射血前期(PEP)、左室射血时间(LVET)、速度指数(VI)、收缩时间比率(STR)、心率(HR)。结果①与正常对照组相比,糖尿病组WHR、FPG、TC、SBP、PP、PEP和STR升高(P<0.05或P<0.01);ACI、VI降低(P<0.01);②与正常对照组相比,糖尿病前期组FPG升高(P<0.01);ACI、VI降低(P<0.05);③相关分析:ACI与BMI、WHR、FPG、SBP、DBP、MAP和HR呈负相关(P<0.01);PEP与BMI呈正相关(P<0.01);VI与BMI、WHR、FPG、SBP、DBP、MAP和HR呈负相关(P<0.01);STR与BMI和WHR呈正相关(P<0.05或P<0.01)。结论中老年糖尿病患者、糖尿病前期患者存在不同程度的心脏血流动力学异常,BMI是引起上述指标改变的共同危险因素;ACI和VI可作为评价糖尿病心脏血流动力学异常的无创性敏感性指标。
Objective To study the characteristics of cardiac hemodynamics in middle-aged and elderly patients with diabetes mellitus, and to explore the sensitive indicators of early detection of diabetic heart disease using non-invasive hemodynamic monitoring system. Methods 218 patients were divided into normal control group (n = 130), pre-diabetes group (n = 23) and diabetic group (n = 65). Body mass index (BMI), WHR, fasting FPG, TG, TC, SBP, DBP, PP and MAP were measured. Cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR), systemic vascular resistance index (SVRI), stroke volume (SV) and stroke index (SI), TFC, ACI, LCWI, PEP, LVET, VI, and time of systolic time (STR), heart rate (HR). Results ①Compared with normal control group, WHR, FPG, TC, SBP, PP, PEP and STR in diabetic group were significantly increased (P <0.05 or P <0.01) (P <0.01), while the ACI and VI decreased (P <0.05). ③ Correlation analysis showed that there was a negative correlation between ACI and BMI, WHR, FPG, SBP, DBP, MAP and HR (P <0.01). There was a positive correlation between PEP and BMI (P <0.01). There was a negative correlation between VI and BMI, WHR, FPG, SBP, DBP, MAP and HR Or P <0.01). Conclusions There are different degrees of cardiac hemodynamic abnormalities in middle-aged and elderly diabetic patients and pre-diabetes patients, and BMI is a common risk factor for these changes. ACI and VI can be used as noninvasive and sensitive indicators for evaluating hemodynamic abnormalities in diabetic patients .