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目的:探讨入院空腹血糖(FPG)水平与合并糖尿病或非糖尿病的慢性心力衰竭(CHF)患者心功能的关系。方法:分析2009-07-2010-09期间收治的161例伴或不伴有糖尿病的CHF患者,心功能为纽约心脏病协会(NYHA)分级Ⅱ～Ⅳ级。以入院FPG不同水平将糖尿病和非糖尿病的患者分组:入院FPG水平<6.1mmol/L组(56例),6.1～7.7 mmol/L组(41例),7.8～11.0 mmol/L组(38例)和≥11.1 mmol/L组(26例)。分析糖尿病和非糖尿病的CHF患者FPG水平与心功能的关系。结果:①与FPG<6.1 mmol/L组的患者比较,6.1～7.7 mmol/L组、7.8～11.0 mmol/L组和≥11.1 mmol/L组的患者中糖尿病的比例较高(P<0.01),体质指数(BMI)、TC、LDL-C升高(P<0.05),左室射血分数(LVEF)较低(P<0.05),心功能Ⅳ级者显著增多(P<0.05)。②用协方差分析校正年龄、性别、BMI、血压、心率、血脂等因素后,在FPG<6.1 mmol/L组、6.1～7.7 mmol/L组和7.8～11.0 mmol/L组,非糖尿病患者LVEF高于糖尿病患者(P<0.05),在FPG≥11.1 mmol/L组低于糖尿病患者(P<0.05)。③采用多元线性回归分析,调整因素包括年龄、BMI、血压、心率、血脂。结果表明:在全部患者、糖尿病患者和非糖尿病患者,FPG水平与LVEF相关联(P<0.05)。结论:不同入院时血糖水平的糖尿病和非糖尿病合并CHF患者的心功能状存在显著差别;与糖尿病患者相比,非糖尿病的CHF患者入院FPG升高很常见,并且与心功能状况显著相关。
Objective: To investigate the relationship between fasting plasma glucose (FPG) admission and cardiac function in patients with or without chronic heart failure (CHF). Methods: A total of 161 CHF patients with and without diabetes mellitus were enrolled during the period of 2009-07-2010-09. Cardiac function was grade Ⅱ ~ Ⅳ in New York Heart Association (NYHA). Diabetic and nondiabetic patients were divided into groups according to different levels of admission FPG: admission FPG level <6.1mmol / L group (56 cases), 6.1-7.7 mmol / L group (41 cases), 7.8-11.0 mmol / L group ) And ≥11.1 mmol / L group (26 cases). To analyze the relationship between FPG level and cardiac function in diabetic and non-diabetic CHF patients. Results: ① Compared with patients with FPG <6.1 mmol / L, the proportion of patients with diabetes in the groups of 6.1-7.7 mmol / L, 7.8-11.0 mmol / L and ≥11.1 mmol / L was higher (P <0.01) , Body mass index (BMI), TC and LDL-C (P <0.05), left ventricular ejection fraction (LVEF) lower (P <0.05) and heart function Ⅳ (P <0.05). ② After adjusting for age, sex, BMI, blood pressure, heart rate, blood lipids and other factors by covariance analysis, LVEF in non-diabetic patients with FPG of 6.1 mmol / L, 6.1-7.7 mmol / L and 7.8-11.0 mmol / (P <0.05), lower than those in patients with diabetes mellitus (FPG≥11.1 mmol / L) (P <0.05). ③ using multiple linear regression analysis, adjustment factors include age, BMI, blood pressure, heart rate, blood lipids. The results showed that in all patients, diabetic patients and non-diabetic patients, FPG levels were associated with LVEF (P <0.05). CONCLUSIONS: There was a significant difference in cardiac function between patients with different glucose levels at admission and those without non-diabetic CHF. Elevated FPG was more common in patients with non-diabetic CHF than in patients with diabetes, and was associated with significant cardiac function.