摘要
目的探讨T2DM合并心功能不全患者血糖波动与高敏C反应蛋白（hsC-RP）的关系。方法将108例T2DM患者分为新诊断T2DM组40例,T2DM＋心功能Ⅰ~Ⅱ级组36例及T2DM＋心功能Ⅲ~Ⅳ级组32例;另选取健康人群（NC）39名。比较各组生化指标、心功能指标。采用动态血糖监测系统（CGMS）连续监测血糖3d;散射比浊法测定hsC-RP。结果 T2DM合并心功能不全各组糖尿病病程、TG、TC、BNP及hsC-RP高于单纯T2DM组,舒张早起流速峰值/舒张晚期流速峰值（E/A）、舒张早期波/舒张晚期波（e/a）、S/D、左室射血分数（LVEF）低于单纯T2DM组（P〈0.05）;日内均血糖波动幅度（MAGE）、最大血糖波动幅度（LAGE）、血糖水平标准差（SDBG）、日间血糖波动绝对差（MODD）及曲线下面积（AUC）均高于NC组和单纯T2DM组（P〈0.05）。相关分析显示,hsC-RP与糖尿病病程、TG、BNP、MAGE、LAGE、SDBG、MODD、AUC呈正相关,与E/A、e/a、S/D、LVEF呈负相关（P〈0.05）;MAGE与糖尿病病程、BNP、E/A、e/a、S/D、LVEF相关（P〈0.05）。多元线性回归分析结果显示,糖尿病病程、E/A、LVEF、MAGE、SDBG及AUC是hsC-RP的影响因素;hsC-RP、BNP、E/A、LVEF、e/a、S/D是MAGE影响因素。结论血糖波动引起T2DM患者血管内皮功能受损及诱导加重炎症反应,导致血管内功能紊乱以及血流阻力增加,进一步引起心肌供血供氧减少,引起心功能不全。
Objective To investigate the relationship between blood glucose fluctuation and high sensitive C reactive protein in patients with type 2diabetes mellitus and cardiac insufficiency. MethodsA total of 108 patients with T2 DM were enrolled in this study and divided into three groups：newly diagnosed T2 DM group（n=40）,T2 DM with cardiac function grade Ⅰ ~ Ⅱ group（n=36）and T2 DM with heart function Ⅲ ~ Ⅳ group（n=32）.And 39 healthy subjects were selected as NC group.Biochemical indexes and cardiac function indexes were compared among groups.Blood glucose was continuously monitored by dynamic blood glucose monitoring system for three days,and hsC-RP was measured by the scattering turbidity method. Results Duration of diabetes,TG,TC,BNP and hsC-RP were higher,and E/A,e/a,S/D,LVEF were lower in T2 DM combined with cardiac insufficiency group than in T2 DM group（P〈0.05）.MAGE,LAGE,SDBG,MODD and AUC were higher in T2DMcombined with cardiac insufficiency group than in NC group and T2 DM group（P〈0.05）.Correlation analysis showed that hsC-RP was positively correlated with duration of diabetes,TG,BNP,MAGE,LAGE,SDBG,MODD,and AUC,and negatively correlated with E/A,e/a,S/D,and LVEF（P〈0.05）.MAGE was associated with duration of diabetes,BNP,E/A,e/a,S/D,and LVEF（P〈0.05）.Multiple liner analysis showed that duration of diabetes,E/A,LVEF,MAGE,SDBG and AUC were influencing factors for hsC-RP,and BNP,E/A,LVEF,e/a,and S/D were influencing factors for MAGE. Conclusion Blood glucose fluctuations can induce inflammatory reaction in patients with T2 DM,lead to vascular dysfunction and increase blood flow resistance,further reduce myocardial blood supply and heart failure.
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2016年第10期902-907,共6页
Chinese Journal of Diabetes
关键词
糖尿病合并心功能不全
血糖波动
高敏C反应蛋白
Diabetic patients with cardiac insufficiency
Blood glucose fluctuations
High sensitive C reactive protein（hsC-RP）
