摘要
目的 观察中青年2型糖尿病合并射血分数保留心力衰竭（HF-PEF）患者的中医证型与糖化血红蛋白（HbA1c）水平,评价其相关性.方法 选取235例在厦门大学附属福州市第二医院心内科门诊及住院就诊的2型糖尿病患者,根据其舒张功能将其分为HF-PEF组120例和非HF-PEF（HF-NPEF）组115例.HF-PEF组按照中医辨证分型分为心气阴虚证、心肾阳虚证、气虚血瘀证、阳虚水泛证.采用高效液相层析法测定HF-PEF组和HF-NPEF组以及HF-PEF组不同中医证型患者的HbA1c水平;并根据血清HbA1c水平7.0%分组,比较不同血清HbA1c水平与HF-PEF患者中医证型严重程度的关系.结果 2型糖尿病合并 HF-PEF组患者血清HbA1c水平显著高于HF-NPEF组〔（7.02±0.74）%比（6.79±0.91）%,P〈0.05〕;HF-PEF 组中心气阴虚证、心肾阳虚证患者的HbA1c水平比较差异无统计学意义〔（6.70±0.66）%比（6.70±0.68）%, P〉0.05〕,而气虚血瘀证和阳虚水泛证患者HbA1c水平明显高于心气阴虚证和心肾阳虚证〔（7.15±0.70）%、（7.55±0.62）%比（6.70±0.66）%、（6.70±0.68）%〕,且阳虚水泛证患者HbA1c水平明显高于气虚血瘀证（P〈0.01）.HbA1c〉7.0%组患者气虚血瘀证＋阳虚水泛证发生率高于HbA1c≤7.0%组〔61.97%（44/71）比38.78%（19/49）,P〈0.05〕.Pearson相关性分析显示,HF-PEF组中,HF-PEF患者数与HbA1c呈正相关（r=0.610,P〈0.05）;HbA1c〉7.0%组中,HbA1c与气虚血瘀证＋阳虚水泛证的患者例数呈正相关（r=0.683,P〈0.05）.结论 血清HbA1c水平对中青年2型糖尿病合并HF-PEF患者的预后评估具有临床一致性,并与中医证型发展呈正相关.
Objective To investigate traditional Chinese medicine （TCM） syndrome differentiations and glycosylated hemoglobin （HbA1c） levels in the young and middle-aged type 2 diabetic patients with heart failure and preserved ejection fraction （HF-PEF）, and to evaluate the correlations between them.Methods 235 out- and hospitalized patients with type 2 diabetes from Department of Cardiology of Affiliated Fuzhou Second Hospital of Xiamen University were enrolled. They were divided into HF-PEF group （120 cases） and non-HF-PEF （HF-NPEF） group （115 cases） according to the diastolic function results of echocardiography. In the HF-PEF group, according to the TCM differentiation of syndromes, the patients were subdivided into four types： heart Qi and Yin deficiency, Yang deficiency of heart and kidney, Qi deficiency and blood stasis and edema syndrome due to Yang deficiency syndromes. The HbA1c levels of different TCM syndromes in HF-PEF and HF-NPEF groups were determined by high performance liquid chromatography. The patients of HF-PEF were further divided into two groups according to serum HbA1c levels 〉 7.0% or ≤ 7.0%, and the relationships between different serum HbA1c levels and different severity of TCM syndrome types of patients with HF-PEF were compared.Results The level of serum HbA1c in HF-PEF group was significantly higher than that in HF-NPEF group in patients with type 2 diabetes [（7.02±0.74）% vs. （6.79±0.91）%,P 〈 0.05]. There was no significant difference in HbA1c levels between heart Qi and Yin deficiency type and Yang deficiency of heart and kidney type in HF-PEF group [（6.70±0.66）% vs. （6.70±0.68）%,P 〉 0.05], while the HbA1c levels of Qi deficiency and blood stasis and edema syndrome due to Yang deficiency syndromes were significantly higher than those of heart Qi and Yin deficiency and Yang deficiency of heart and kidney types [（7.15±0.70）%, （7.55±0.62）% vs. （6.70±0.66）%, （6.70±0.68）%], and the HbA1c levels of edema syndrome due to Yang De
出处
《中国中西医结合急救杂志》
CAS
北大核心
2015年第5期504-507,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
福建省福州市科技计划项目（2011-S-67-5）
关键词
中青年2型糖尿病
射血分数保留心力衰竭
糖化血红蛋白
心力衰竭中医证型
Young and middle-aged type 2 diabetes
Heart failure with preserved ejection fraction
Glycosylated hemoglobin
Traditional Chinese medicine syndrome types of heart failure
